首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献，搜索用时 31 毫秒
1.
Background – To review the physics of helium with regard to airway physiology, as well as known human and potential veterinary applications of administration of inhaled helium‐oxygen gas‐carrier mixture (heliox). Data Sources – Human and veterinary studies. Human Data Synthesis – Helium‐oxygen mixtures have been used in human medicine for over 70 years as an adjunct therapy in various upper and lower respiratory disorders. Helium's low density promotes laminar flow through partially obstructed airways, resulting in a decreased work of breathing. Veterinary Data Synthesis – Little to no evidence‐based medicine exists to support or oppose the use of heliox in veterinary species. However, domestic animal species and humans share several common pathophysiologic aspects of various obstructive airway disorders. Thus, veterinary patients may also ultimately and significantly benefit from this novel therapy. Conclusion – Prospective studies are needed in veterinary medicine to determine the utility of heliox in clinical scenarios.  相似文献   

2.
Objective – Review the historical development and physiologic principles of hyperbaric oxygen therapy (HBOT) based on human and veterinary experimental literature and current equipment in use. Data Sources – Review of basic physiologic concepts. Data from human and veterinary journals were reviewed through Pubmed and Veterinary Information Network database searches as well as reference searches on several articles covering hyperbaric therapy in clinically applicable situations. Human Data Synthesis – HBOT has been gaining acceptance as an adjunctive treatment in human medicine. The understanding of the physiology and application of hyperbaric therapy is increasing through ongoing research and greater access to hyperbaric equipment. Veterinary Data Synthesis – Several animal models have been utilized to examine the effects of HBOT. Most models utilize dogs and rats but pigs, cats, and other species have been studied. Conclusions – Hyperbaric therapy utilizes several physiologic principles of how gases respond under pressure and more specifically of how oxygen responds under pressure. The increase in concentration of oxygen in solution, based on its solubility under pressure, increases the diffusion gradient for its delivery deeper into tissues, which is the premise of HBOT. Ultimately the increases in dissolved oxygen generated by hyperbaric therapy have several physiologic effects that can alter tissue responses to disease and injury. As this technology becomes more available to clinical practice, HBOT should be considered as a therapeutic option.  相似文献   

3.
Objective – To describe and review both traditional and newer diagnostic and therapeutic options for canine and feline ureteral obstructions currently being performed clinically in veterinary medicine. Data Sources – A Medline search with no date restrictions was used for this review. Human Data Synthesis – The human literature would support the use of minimally invasive endourological techniques for the treatment of nearly all causes of ureteral obstructions, whenever possible. This typically includes extracorporeal shockwave lithotripsy, intracorporeal lithotripsy via retrograde ureteroscopy or antegrade percutaneous nephroureterolithotomy, ureteral stenting, percutaneous nephrostomy tube placement, and laparoscopic endopyelotomy. Typically open surgery is only suggested in cases of ureteral or gynecological malignancy when en bloc resection is considered a good option, or when various methods of endourological techniques have failed. Veterinary Data Synthesis – The veterinary literature is scarce on the use of interventional endourological techniques for the treatment of ureteral obstructions and has been growing over the last 5 years. The current literature reports the use of extracorporeal shockwave lithotripsy for ureteral stones, as well as the use of ureteral stents for the treatment of trigonal obstructive transitional cell carcinoma, ureterolithiasis, and ureteral strictures. Traditional surgical interventions, like ureterotomy, ureteronephrectomy, and ureteral reimplantation is more vastly reported and accepted. This review will focus on new clinical data using interventional endourological techniques for ureteral obstructions. Conclusions – Various treatment options for ureteral obstructions are now available for veterinary patients, and the trend away from traditional surgical techniques will hopefully be followed now that they are technically and clinically available for dogs and cats.  相似文献   

4.
Objective – To review the human and veterinary literature on histamine physiology and pathophysiology and potential applications for clinical use in veterinary critical care. Data Sources – Human and veterinary clinical studies, reviews, texts, and recent research in histamine receptor and antagonist therapy. Human Data Synthesis – Recent progress in molecular biology has led to a more complete understanding of the enzymes involved in histamine metabolism and histamine receptor physiology. The past decade of research has confirmed the role of histamine in the classical functions (contraction of smooth muscle, increase in vascular permeability, and stimulation of gastric acid secretion) and has also elucidated newer ones that are now under investigation. Data on the roles of histamine in angiogenesis, circadian rhythm, bone marrow regeneration, bacterial eradication, and cancer are emerging in the literature. Newer histamine antagonists are currently in drug trials and are expected to advance the clinical field in treatment of allergic, gastrointestinal, and cognitive disorders. Veterinary Data Synthesis – Veterinary histamine research is directed at identifying the effects of certain pharmacological agents on blood histamine concentrations and establishing the relevance in clinical disease states. Research demonstrates important species differences in regards to histamine receptor physiology and tissue response. Studies in the area of trauma, sepsis, anaphylaxis, allergy, and gastrointestinal disorders have direct applications to clinical veterinary medicine. Conclusions – Histamine plays a key role in the morbidity and mortality associated with allergy, asthma, gastric ulcers, anaphylaxis, sepsis, hemorrhagic shock, anesthesia, surgery, cardiovascular disease, cancer, CNS disorders, and immune‐mediated disease. Histamine antagonism has been in common use to block its adverse effects. With recent advances in the understanding of histamine receptor physiology, pharmaceutical agents targeting these receptors have increased the therapeutic options.  相似文献   

5.
Objective – Review the mechanisms of action and clinical application of hyperbaric oxygen therapy (HBOT) based on human and veterinary clinical and experimental literature. Data Sources – Pubmed and Veterinary Information Network databases were searched for human and veterinary journal articles on hyperbaric therapy in clinically applicable situations. Historical reference searches on several articles in addition to basic physiologic concepts were also reviewed. Human Data Synthesis – HBOT has gained acceptance as an adjunctive treatment in clinical conditions other than diving‐related injuries, such as select problem wounds and central nervous system diseases, in human medicine. Access to hyperbaric therapy has increased and ongoing research has furthered understanding of the mechanisms and potential therapeutic uses of HBOT. Veterinary Data Synthesis – Several animal models have been utilized to examine the effects of HBOT; primarily rodents (mice, rats) and rabbits but also dogs, cats, and pigs. Data related to animal model research as it pertains to clinical application of HBOT is reviewed. Conclusions – There is a substantial body of literature that has examined the adverse and beneficial effects of HBOT in animal models. As technology becomes more readily available to clinical practice and more clinical trials are performed to define its effectiveness, HBOT may be considered as an additional therapeutic option in many conditions including select problem wounds, spinal cord injury, and cerebral ischemic injury. Understanding the mechanisms by which HBOT exerts its effects will help guide research and use of the modality in clinical patients.  相似文献   

6.
Objective – To review the human and veterinary literature on the biology of apoptosis in health and disease. Data Sources – Data were examined from the human and veterinary literature identified through Pubmed and references listed in appropriate articles pertaining to apoptosis. Human Data Synthesis – The role of apoptosis in health and disease is a rapidly growing area of research in human medicine. Apoptosis has been identified as a component of human autoimmune diseases, Alzheimer's disease, cancer, and sepsis. Veterinary Data Synthesis – Research data available from the veterinary literature pertaining to apoptosis and its role in diseases of small animal species is still in its infancy. The majority of veterinary studies focus on oncologic therapy. Most of the basic science and human clinical research studies use human blood and tissue samples and murine models. The results from these studies may be applicable to small animal species. Conclusions – Apoptosis is the complex physiologic process of programmed cell death. The pathophysiology of apoptosis and disease is only now being closely evaluated in human medicine. Knowledge of the physiologic mechanisms by which tissues regulate their size and composition is leading researchers to investigate the role of apoptosis in human diseases such as cancer, autoimmune disease and sepsis. Because it is a multifaceted process, apoptosis is difficult to target or manipulate therapeutically. Future studies may reveal methods to regulate or manipulate apoptosis and improve patient outcome.  相似文献   

7.
Objective – To review the use of IV lipid emulsion (ILE) for the treatment of toxicities related to fat‐soluble agents; evaluate current human and veterinary literature; and to provide proposed guidelines for the use of this emerging therapy in veterinary medicine and toxicology. Data Sources – Human and veterinary medical literature. Human Data Synthesis – Human data are composed mostly of case reports describing the response to treatment with ILE as variant from mild improvement to complete resolution of clinical signs, which is suspected to be due to the variability of lipid solubility of the drugs. The use of ILE therapy has been advocated as an antidote in cases of local anesthetic and other lipophilic drug toxicoses, particularly in the face of cardiopulmonary arrest and unsuccessful cardiopulmonary cerebral resuscitation. Veterinary Data Synthesis – The use of ILE therapy in veterinary medicine has recently been advocated by animal poison control centers for toxicoses associated with fat‐soluble agents, but there are only few clinical reports documenting successful use of this therapy. Evidence for the use of ILE in both human and veterinary medicine is composed primarily from experimental animal data. Conclusions – The use of ILE appears to be a safe therapy for the poisoned animal patient, but is warranted only with certain toxicoses. Adverse events associated with ILE in veterinary medicine are rare and anecdotal. Standard resuscitation protocols should be exhausted before considering this therapy and the potential side effects should be evaluated before administration of ILE as a potential antidote in cases of lipophilic drug toxicoses. Further research is waranted.  相似文献   

8.
Objective – To review the human and veterinary literature on the pathophysiology of myasthenia gravis (MG) and describe treatment options for clinical use in people and animals. Data Sources – Human and veterinary clinical reports, studies and reviews, textbooks, and recent research findings in MG from 1996 present, with a focus on treatment and patient management. Human Data Synthesis – MG is a well‐described condition in people with new research and treatment options available. Many of the newest therapeutic options available in veterinary medicine for MG are based on current strategies used in people with this condition. Seronegative MG is well described in people and provides insight to clinical cases encountered in veterinary medicine when the index of suspicion is high though serologic tests are negative. Veterinary Data Synthesis – Previous studies in veterinary medicine focused on the use of acetylcholinesterase inhibitors as the main form of treatment in canine MG. Recent studies, mainly case series and case reports, emphasize the use of immunomodulatory treatments as an alternative for long‐term treatment. However, there are no randomized, controlled studies on treatment with immunomodulatory therapy for MG in dogs available to assess the efficacy of this treatment strategy. Conclusions – Although early recognition of clinical signs is most important in the outcome of patients with MG, further understanding the pathophysiology of MG may lead to earlier diagnosis and novel treatment strategies. The discovery of additional autoantibodies against striated muscle proteins in dogs, should enhance our understanding of diseases affecting the neuromuscular junction. In addition, clinical data for canine MG could be applied to other autoimmune disorders.  相似文献   

9.
Objective – To review the use of impedance threshold devices (ITD) during CPCR, their proposed mechanism of action, and their application in veterinary medicine. Data Sources – Data sources include scientific reviews and original research publications using the PubMed search engine with the following keywords: ‘impedance threshold device’ and ‘resuscitation’ and the Veterinary Information Network search function using the keywords ‘impedance threshold device.’ Human Data Synthesis – Studies in human medicine have demonstrated that the use of an ITD during CPCR in patients during out‐of‐hospital cardiac arrest improves coronary perfusion pressure and cerebral perfusion pressure. This improvement in vital organ blood flow results in increased cardiac output and faster return of spontaneous circulation. The use of an ITD has been studied in people and currently holds a class IIb level of recommendation according to the 2010 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care. This device is recommended as a way to improve hemodynamics during CPCR by enhancing venous return and avoiding hyperventilation, thereby increasing the likelihood of a successful resuscitation. Veterinary Data Synthesis – Multiple controlled studies using pigs with ventricular fibrillation induced cardiopulmonary arrest have demonstrated increased myocardial and cerebral perfusion with the use of an ITD. These studies have emphasized the importance of decreasing intrathoracic pressures during the decompression phase of CPCR and avoiding hyperventilation in order to maximize vital organ blood flow. Conclusions – Use of an ITD during CPCR in human and animal studies has demonstrated improved vital organ perfusion and faster return of spontaneous circulation. However, the majority of these studies have been carried out in people during out‐of‐hospital cardiac arrest and ventricular fibrillation cardiopulmonary arrest pig models. Further studies evaluating the use of an ITD during CPCR in the veterinary hospital setting are warranted.  相似文献   

10.
Objectives – To review the nonradiologist use of ultrasound (US) in the setting of emergency and critical care, the development, clinical applications, and standardization of veterinary abdominal and thoracic focused assessment with sonography for trauma (FAST) techniques. Etiology – Since the 1990s, the 4‐point FAST US technique has been used for injury surveillance in people with blunt and penetrating trauma. FAST screens for free fluid in the abdominal, pleural, and pericardial cavities with high sensitivity and specificity. More recently, an extended FAST scan was developed for the rapid detection of pneumothorax. These techniques and newly created scans have been applied to other critically ill, nontraumatized, subsets of human patients. As a result, the terminology related to this field, eg, extended FAST, HHFAST, FFAST, FAFF, BOAST, SLOH, bedside US, ‘$ Approach,’ protocols, and objectives have become convoluted despite having similar goals. Diagnosis – The importance of US in the setting of emergency medicine is highlighted by the fact that this diagnostic modality has become an integral part of the core curriculum for nonradiologists including the American College of Surgeons, American College of Emergency Physicians, American Board of Emergency Medicine, Society of Academic Emergency Medicine, and all United States Accreditation Council for Graduate Medical Education Emergency Medicine residency programs. Therapy – Veterinary applications of FAST techniques include an abdominal FAST technique with an abdominal FAST applied fluid scoring system, and a thoracic FAST technique. In an attempt to avoid the creation of numerous acronyms, veterinarians would be well served by making the ‘T’ in ‘FAST’ stand for ‘Trauma,’‘Triage,’ and ‘Tracking.’ Prognosis – These veterinary FAST techniques provide an extension of the physical examination for the emergency and critical care veterinarian potentially expediting diagnosis, prompting life‐saving maneuvers, and guiding patient management. Further clinical research to determine sensitivity, specificity, and accuracy for specific conditions is warranted.  相似文献   

11.
Objective: To review the recent human and veterinary literature on current adrenergic receptor physiology/pathophysiology and potential applications in veterinary critical care. Data sources: Human and veterinary clinical studies, reviews, texts, and recent research in receptor molecular biology. Human data synthesis: Recent development of molecular cloning and other biological research techniques has advanced the field of adrenergic physiology. The past decade of research has made available new knowledge of adrenergic receptor subtypes as well as their locations and functions. Many of the diagnostic compounds used in biochemical research to distinguish between α‐ and β‐receptor subtypes may emerge as important additions to the arsenal of cardiovascular pharmaceuticals. Veterinary data synthesis: Veterinary adrenoceptor research is typically directed at investigating the effects of commercially available medications. Such studies demonstrate important species differences in addition to potential side effects and new indications for therapy. Many of the human molecular biology studies are performed on animal species, which can have direct application to veterinary medicine. Conclusions: Proper cardiovascular responses are essential to maintaining tissue perfusion and cellular homeostasis. α‐ and β‐adrenergic receptors play a vital role not only in the pathophysiology but also in the therapy of diseases involving the cardiovascular system. For adrenergic pharmacotherapy to be successfully used, a thorough understanding of the mechanisms underlying adrenoceptor physiology is necessary. Recent research has illuminated various subsets within the α‐ and β‐receptor classifications. Awareness of currently available and emerging adrenoceptor subtype‐specific treatment options allows precise pharmacologic targeting of disease processes in critical illness.  相似文献   

12.
Objective – To review the pathophysiology, clinical signs, diagnosis, and treatment of pulmonary thromboembolism (PTE) in small animals. Data Sources – Human and veterinary clinical studies, reviews, texts, and recent research in canine and feline PTE diagnosis and thromboembolic therapeutics. Human Data Synthesis – In humans, clinical probability assessment and point‐of‐care D‐dimer‐based algorithms are widely used. Computed tomography pulmonary angiography is the gold standard for PTE diagnosis in humans. Echocardiography is increasingly used for bedside assessment of affected patients. In low‐risk human patients anticoagulants alone are recommended while patients with cardiogenic shock are treated with thrombolytics followed by anticoagulation. Veterinary Data Synthesis – PTE is associated with numerous predisposing conditions causing hypercoagulability, blood flow stasis, or endothelial injury. Identifying at‐risk patients is key to diagnosis in small animals. Thromboelastography provides a method for identifying hypercoagulable patients. Computed tomography pulmonary angiography may replace selective pulmonary angiography as the imaging technique of choice for PTE diagnosis. PTE therapy consists of supportive treatment combined with appropriate, individualized thromboembolic pharmacotherapy for acute treatment and chronic management. Thrombolytic therapy for PTE remains controversial but may be indicated in hemodynamically unstable acute PTE. Thromboprophylaxis in specific conditions is rational although evidence of efficacy is limited. Prognosis depends upon degree of cardiopulmonary compromise and patient response to therapy. Mortality rates in small animals are unknown. Conclusions – New diagnostic techniques and advances in therapy offer significant potential for improvements in the identification and treatment of PTE in small animals. Further study must be directed to validating new diagnostic modalities and evaluating therapeutic regimes.  相似文献   

13.
Objective – To review the evolution of and controversies associated with allogenic blood transfusion in critically ill patients. Data sources – Veterinary and human literature review. Human Data Synthesis – RBC transfusion practices for ICU patients have come under scrutiny in the last 2 decades. Human trials have demonstrated relative tolerance to severe, euvolemic anemia and a significant outcome advantage following implementation of more restricted transfusion therapy. Investigators question the ability of RBCs stored longer than 2 weeks to improve tissue oxygenation, and theorize that both age and proinflammatory or immunomodulating effects of transfused cells may limit efficacy and contribute to increased patient morbidity and mortality. Also controversial is the ability of pre‐ and post‐storage leukoreduction of RBCs to mitigate adverse transfusion‐related events. Veterinary Data Synthesis – While there are several studies evaluating the transfusion trigger, the RBC storage lesion and transfusion‐related immunomodulation in experimental animal models, there is little research pertaining to clinical veterinary patients. Conclusions – RBC transfusion is unequivocally indicated for treatment of anemic hypoxia. However, critical hemoglobin or Hct below which all critically ill patients require transfusion has not been established and there are inherent risks associated with allogenic blood transfusion. Clinical trials designed to evaluate the effects of RBC age and leukoreduction on veterinary patient outcome are warranted. Implementation of evidence‐based transfusion guidelines and consideration of alternatives to allogenic blood transfusion are advisable.  相似文献   

14.
Objective – To review the veterinary and human literature on the role of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in health and disease states.
Data Sources – Original research articles and scientific reviews from both human and veterinary literature were searched for relevance to TF and TFPI.
Human Data Synthesis – Interest in both TF and TFPI has grown widely over the last several years. The impact TF plays in coagulation, inflammation, angiogenesis, tumor metastasis, and cellular signaling has become apparent. Treatment with TFPI for severe sepsis has been examined and is still currently under investigation. Inhibition of the TF pathway is being studied as an aid in the treatment of neoplasia. The important physiologic and pathophysiologic role these molecules play has only begun to be understood.
Veterinary Data Synthesis – There is a paucity of publications that discuss the importance of TF and TFPI in veterinary medicine. An enhanced understanding of the TF pathway in human medicine, in experimental animal models treating sepsis with TFPI, and in animal models demonstrating the proangiogenic properties of TF provides relevance to veterinary medicine.
Conclusion – It is apparent that TF and TFPI are important in health and disease. An enhanced understanding of the physiologic and pathophysiologic roles of these factors provides better insight into coagulation, inflammation, angiogenesis, disseminated intravascular coagulation, and tumor metastasis. This greater understanding may provide for the development of therapeutics for sepsis, disseminated intravascular coagulation, and neoplasia.  相似文献   

15.
Objective – To provide a review of clinically relevant observations related to Bartonella species as emerging pathogens in veterinary and human medicine.
Data Sources – Literature as cited in PubMed and as generated by each of the authors who have contributed to various aspects of the clinical understanding of bartonellosis.
Human Data Synthesis – Important historical and recent publications illustrating the evolving role of animal reservoirs as a source of human infection.
Veterinary Data Synthesis – Comprehensive review of the veterinary literature.
Conclusions – In addition to inducing life-threatening illnesses, such as endocarditis, myocarditis, and meningoencephalitis and contributing to chronic debilitating disease, such as arthritis, osteomyelitis, and granulomatous inflammation in cats, dogs, and potentially other animal species; pets and wildlife species can serve as persistently infected reservoir hosts for the transmission of Bartonella spp. infection to veterinary professionals and others with direct animal contact.  相似文献   

16.
Objective – The aim of this review is to describe and evaluate both conventional and molecular diagnostic testing utilized in dogs and cats with acute neurologic diseases. Various types of polymerase chain reaction (PCR) are explored along with novel molecular diagnostic testing that ultimately may prove useful in the critical care setting. Data Sources – PUBMED was searched to obtain relevant references material using keywords: ‘canine OR feline meningitis AND meningoencephalitis,’‘feline infectious peritonitis,’‘canine distemper,’‘canine OR feline AND toxoplasma,’‘canine neospora,’‘canine OR feline AND rickettsia,’‘granulomatous meningoencephalitis,’‘steroid responsive meningitis arteritis,’‘necrotizing encephalitis,’‘novel neurodiagnostics,’‘canine OR feline AND CNS borrelia,’‘canine OR feline AND CNS bartonella,’‘canine OR feline AND CNS fungal,’‘nested OR multiplex OR degenerate OR consensus OR CODEHOP AND PCR.’ Research findings from the authors' laboratory and current veterinary textbooks also were utilized. Human Data Synthesis – Molecular diagnostic testing including conventional, real‐time, and consensus and degenerate PCR and microarray analysis are utilized routinely for the antemortem diagnosis of infectious meningoencephalitis (ME) in humans. Recently, PCR using consensus degenerate hybrid primers (CODEHOP) has been used to identify and characterize a number of novel human viruses. Veterinary Data Synthesis – Molecular diagnostic testing such as conventional and real‐time PCR aid in the diagnosis of several important central nervous system infectious agents including canine distemper virus, Toxoplasma gondii, Neospora caninum, rickettsial species, and others. Recently, broadly reactive consensus and degenerate PCR reactions have been applied to canine ME including assays for rickettsial organisms, Borrelia spp. and Bartonella spp., and various viral families. Conclusions – In the acute neurologic patient, there are several key infectious diseases that can be pursued by a combination of conventional and molecular diagnostic testing. It is important that the clinician understands the utility, as well as the limitations, of the various neurodiagnostic tests that are available.  相似文献   

17.
Objective – To review the human and veterinary literature regarding the neurophysiology of dyspnea and to provide evidence for the beneficial effects of several novel therapies aimed at the alleviation of dyspneic sensations. Data Sources – Data sources included scientific reviews, case reports, original research publications, and recent research conference proceedings. Human Data Synthesis – The use of blood oxygenation level‐dependent functional magnetic resonance imaging technology has revealed that the brain regions activated by air hunger in humans are also those activated by fear, pain, and thirst perception. In human subjects, it has been found that agents known to enhance the firing of pulmonary slowly adapting receptors (SARs) can alleviate the sensation of dyspnea without altering central respiratory drive. Several small studies have also shown that nebulized opioids can reduce the sensation of dyspnea apparently via activation of peripheral opioid receptors in the lung. Veterinary Data Synthesis – There are several animal models relevant to both small and large animal clinical patient populations. Treatment of rats with a nebulized SAR sensitizing agent (furosemide) enhances SAR firing in response to lung inflation. Behavioral escape responses to airway occlusion are reduced in lightly anesthetized cats when treated with nebulized furosemide. Opioid agonists have been shown to inhibit the release of acetylcholine and other mediators from the airways of dogs and guinea pigs. Studies using a goat model with bilateral destruction of the pre‐Bötzinger Complex do not support current paradigms of air hunger origination. Conclusions – Veterinary patients may benefit from an approach to dyspnea that incorporates an understanding of the origins of the unpleasant sensations associated with the condition. Several novel therapies have shown promise in alleviating dyspneic sensations without altering respiratory drive. Further study is needed to determine the safety and efficacy of these therapies in veterinary patients.  相似文献   

18.
Objective: To review the use of cardiac troponins as biomarkers for myocardial injury in human and veterinary medicine. Data sources: Data sources included scientific reviews and original research publications. Human data synthesis: Cardiac troponins have been extensively studied in human medicine. Finding an elevated cardiac troponin level carries important diagnostic and prognostic information for humans with cardiovascular disease. Troponin assays are used primarily to diagnose acute myocardial infarction in patients with ischemic symptoms such as chest pain. However, elevated blood levels may be found with any cause of myocardial injury. Veterinary data synthesis: Several studies have shown that cardiac troponins are sensitive and specific for myocardial damage in veterinary patients and may have utility in diagnosis and prognosis for certain disease states. Human assays may be used in most animals due to significant homology in the troponin proteins between species. Conclusions: Cardiac troponins are sensitive and specific markers of myocardial injury although they do not give any information regarding the mechanism of injury. They have redefined how acute myocardial infarction is diagnosed in humans. Their use in the clinical management of veterinary patients is limited at this time. Further prospective studies are warranted.  相似文献   

19.
Objective – To review zinc physiology and pathophysiology and the importance of zinc toxicity and deficiency in veterinary patients.
Data Sources – A review of human and veterinary medical literature.
Human Data Synthesis – There is a significant amount of original research in humans and animals on the role of zinc in multiple organ systems. There is also significant data available on human patients with zinc abnormalities.
Veterinary Data Synthesis – Zinc deficiency has been studied in dogs with genetic disease and dietary deficiency leading to dermatological disease and immune deficiency. Zinc toxicity has been described after ingestion of metallic foreign bodies containing zinc.
Conclusions – Historically, the role of zinc in health and disease has been studied through patients with toxicity or severe deficiency with obvious clinical signs. As the ubiquitous contribution of zinc to structure and function in biological systems was discovered, clinically significant but subtle deficiency states have been revealed. In human medicine, mild zinc deficiencies are currently thought to cause chronic metabolic derangement leading to or exacerbating immune deficiency, gastrointestinal problems, endocrine disorders, neurologic dysfunction, cancer, accelerated aging, degenerative disease, and more. Determining the causal relationships between mild zinc deficiency and concurrent disease is complicated by the lack of sensitive or specific tests for zinc deficiency. The prevalence of zinc deficiency and its contribution to disease in veterinary patients is not well known. Continued research is warranted to develop more sensitive and specific tests to assess zinc status, to determine which patients are at risk for deficiency, and to optimize supplementation in health and disease.  相似文献   

20.
Laparoscopic surgery is entrenched within human medicine and offers many advantages over traditional laparotomy procedures. Such techniques have filtered down into veterinary medicine, with some practitioners now routinely performing endoscopic oophorectomy in dogs. However, until the recent development of miniature laparoscopy instruments for human pediatrics, such procedures were not possible in small exotic mammals. By combining the commonly used 2.7-mm endoscopic system with 3-mm instruments, laparoscopic surgery has now become a reality in exotic mammal practice. This article summarizes the required equipment and the surgical approach to performing endoscopic oophorectomy in pet rabbits, and serves as a useful model for endosurgery in small exotic mammals.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号