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1.
Objective – To compare the histopathologic diagnosis in dogs with spontaneous hemoperitoneum when abdominal ultrasonographic examination detects a solitary versus multiple lesions.
Design – Retrospective cross-sectional study.
Setting – Private veterinary hospital.
Animals – Client-owned dogs presented with spontaneous hemoperitoneum between March 1, 2003 and June 1, 2008.
Interventions – Dogs were divided into 2 groups based on presence of a solitary or multiple abdominal ultrasonographic lesions. Prevalences were compared between groups for malignancy and specifically hemangiosarcoma.
Measurements and Main Results – Ten of 31 (32%) dogs had a solitary abdominal ultrasonographic lesion and 21 of 31 (68%) had more than 1 lesion. The bleeding tissue was characterized as malignant in 8 of 10 (80%) dogs with solitary lesions and 17 of 21 (81%) dogs with multiple lesions; there was no significant difference ( P =1.0) between groups. In this study no association ( P =0.26) was found between the number of abdominal ultrasonographic lesions observed and subsequent diagnosis of hemangiosarcoma.
Conclusions – Solitary abdominal ultrasonographic lesions in dogs with spontaneous hemoperitoneum do not necessarily indicate a lower prevalence of malignancy.  相似文献   

2.
Background: Bile peritonitis is a severe, nonseptic inflammatory response to bile in the peritoneal cavity. It may result from generalized or localized leakage of bile due to spontaneous rupture of the biliary system or as a complication of biliary tract inflammation, obstruction, manipulation, or trauma. Cytologically, bile in abdominal fluid appears as golden-green granular pigment.
Objective: The purpose of this report is to describe the atypical cytologic features of abdominal fluid in 3 dogs with bile peritonitis.
Methods: As part of a diagnostic workup, abdominal fluid was obtained from 3 dogs with bile peritonitis and analyzed. In 2 dogs, fluid bilirubin concentration was determined and Hall's bile stain, Alcian blue-periodic acid-Schiff stain, and Mayer's mucicarmine stain were applied to direct smears of the fluid.
Results: Acellular mucinous fibrillar material in clumps and lakes was the prominent cytologic finding in the abdominal fluid from all 3 dogs. Bile pigment was not observed. Fluid from the 3 dogs contained increased numbers of inflammatory cells, predominantly neutrophils. Total protein concentration ranged from 2.9 to 5.6 g/dL. Fluid total bilirubin concentration was greater than twice that of the concurrent serum bilirubin concentration. Based on results of the special stains, the amorphous material was positive for mucosubstances, but was negative for bilirubin. In all dogs, bile peritonitis originated from a rent in the common bile duct.
Conclusions: Bile peritonitis with fibrillar mucinous material in abdominal fluid has not been described previously in dogs. The material was similar to "white bile" observed in humans and experimentally in dogs as a sequela to extrahepatic biliary tract obstruction. When mucinous material is observed in abdominal fluid from dogs and the fluid bilirubin concentration is greater than twice the serum bilirubin concentration, rupture of the extrahepatic biliary tract should be suspected.  相似文献   

3.
OBJECTIVE: To establish a focused assessment with sonography for trauma (FAST) protocol in dogs, determine whether FAST can be performed by veterinary clinicians without extensive ultrasonographic experience, and assess the frequency of free fluid (as determined via FAST) in the abdominal cavity of dogs following motor vehicle accidents (MVAs). DESIGN: Prospective study. ANIMALS: 100 client-owned dogs evaluated within 24 hours of an MVA. PROCEDURE: Dogs were placed in lateral recumbency for the FAST examination. To detect fluid in the abdomen, 2 ultrasonographic views (transverse and longitudinal) were obtained at each of 4 sites (just caudal to the xiphoid process, on the midline over the urinary bladder, and at the left and right flank regions). RESULTS: In the 100 dogs evaluated via FAST, free abdominal fluid was detected in 45 dogs. In 40 of those 45 dogs, abdominocentesis was performed; hemoperitoneum and uroperitoneum were diagnosed in 38 and 2 dogs, respectively. Compared with dogs that had no free abdominal fluid detected via FAST, dogs that had free abdominal fluid detected via FAST had significantly higher heart rates and serum lactate concentrations and significantly lower PCVs and total solid concentrations. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicate that FAST is a simple and rapid technique that can be performed on dogs in an emergency setting to detect intra-abdominal free fluid and can be performed by veterinary clinicians with minimal previous ultrasonographic experience.  相似文献   

4.
Introduction:  Canine hemangiosarcoma (HSA) is a fatal malignancy and most dogs die within 6–8 months of diagnosis. The spleen is a common primary site, representing 50% of all cases. These dogs typically present with clinical signs due to tumor rupture and intra‐abdominal dissemination; the abdomen is also the main site of disease progression when these patients fail. Direct delivery of chemotherapy into the abdominal cavity may therefore be a rational approach in this malignancy.
Methods:  14 dogs with stage 2 or 3 splenic HSA were recruited. Doxil at a dose of 1 mg/kg was diluted in saline and administered via ultrasound‐guidance into the abdominal cavity. The dogs were scheduled to receive 4 treatments every 3 weeks. Samples of plasma and abdominal fluid were collected for pharmacokinetic analysis. All dogs were monitored for recurrence and complete necropsies were requested at death.
Results:  8 dogs with stage 3 and 6 dogs with stage 2 HSA were enrolled. All 14 dogs have died, 12/14 due to tumor and 2 from other causes. There was no difference in median survival days between stages (stage 2: 244, stage 3: 125, p = .22). All 12 dogs that died due to tumor‐related causes failed with intra‐abdominal recurrence. Necropsies showed that the dogs in this study had relatively fewer extra‐abdominal metastasis compared to dogs treated with systemic chemotherapy. Pk analysis showed detectable plasma doxorubicin 1 and 2 weeks after treatment.
Conclusion:  Direct abdominal administration of Doxil did not prevent intra‐abdominal recurrence; however, it appeared to provide effective systemic coverage.  相似文献   

5.
Objective— To describe the safety, surgical time, and complications associated with 3 techniques for achieving hemostasis during laparoscopic-assisted ovariohysterectomy (LAOVH).
Study Design— Prospective, randomized clinical trial.
Animals— Female dogs ( n =30).
Methods— Dogs were randomly assigned to 1 of 3 methods for achieving ovarian pedicle hemostasis during LAOVH: extracorporeal modified Roeder knot application (suture group), metal clip application using a multifire 10 mm laparoscopic clip applier (clip group), or use of a novel 5 mm bipolar vessel-sealing device (vessel-sealing group). In all dogs a 3 median portal technique was used.
Results— Controlling for the dogs' bodyweights, there was a significant association between surgical time and which method for hemostasis was used. This association was different when comparing the first 5 procedures using each method to the second 5. For a 20 kg dog, the surgical time (95% CI) for the first 5 procedures was 80 (69–91), 68 (57–79), and 33 (21–45) minutes for the suture, clip, and vessel-sealing groups, respectively. For the second 5 procedures surgical time was 71 (60–81), 50 (39–60), and 40 (29–51) minutes. Pedicle hemorrhage occurred in all dogs in the clip group, 3 dogs in the suture group, and none of the dogs in the vessel-sealing group although in all cases was considered hemodynamically inconsequential. All dogs recovered uneventfully.
Conclusions— All methods of hemostasis were safe for pedicle sectioning. A learning curve exists for clip and suture methods.
Clinical Relevance— Use of a vessel-sealing device significantly shortens surgical time and provides excellent hemostasis during LAOVH.  相似文献   

6.
Objective: To determine the clinical efficacy of abdominal fluid to peripheral blood ratios of creatinine and potassium concentrations to diagnose uroperitoneum in dogs.
Design: Records of 13 dogs with confirmed uroabdomen were retrospectively analyzed. Prospective evaluation of 8 dogs with nonrenal ascites provided data for a control population.
Setting: Veterinary Medical Teaching Hospital.
Animals: Client owned dogs.
Interventions: None
Measurements and Main Results: Abdominal fluid potassium (mEq/L) and creatinine concentrations (mg/dl) were recorded. Peripheral blood potassium and creatinine concentrations were also recorded. Ratios were calculated based on these values. An abdominal fluid creatinine concentration to peripheral blood creatinine concentration ratio of > 2:1 was predictive of uroabdomen in dogs (specificity 100%, sensitivity 86%). An abdominal fluid potassium concentration to peripheral blood potassium concentration of > 1.4:1 is also predictive of uroabdomen in dogs (specificity 100%, sensitivity 100%). All dogs with uroabdomen had an abdominal fluid creatinine concentration that was at least 4 times normal peripheral blood levels.
Conclusion: Abdominal fluid to peripheral blood potassium and creatinine ratios provide a means to diagnose uroperitoneum in dogs without elevated peripheral blood creatinine.  相似文献   

7.
Background: Choroid plexus tumors (CPTs) comprise approximately 10% of all primary brain tumors in dogs. The clinical utility of magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, or both in the presumptive diagnosis of CPTs has not been determined.
Objectives: To report MRI and CSF findings in dogs with CPT and determine if there are distinguishing features that allow clinical discrimination between the tumor grades.
Animals: Fifty-six client-owned dogs with naturally occurring CPT.
Methods: Retrospective case series. The inclusion criterion was histologically confirmed CPT. Blinded review of cranial MRI and cisternal CSF analysis was performed.
Results: Thirty-six of 56 dogs had a choroid plexus carcinoma (CPC) and 20 had a choroid plexus papilloma (CPP). Golden Retrievers were overrepresented compared with the hospital population (frequency 3.7 times that expected, confidence interval 95%= 2.0–6.7, P < .0002). Median CSF protein concentration in CPCs (108 mg/dL, range 27–380 mg/dL) was significantly higher than in CPPs (34 mg/dL, range 32–80 mg/dL) ( P = .002). Only dogs with CPCs had a CSF protein concentration >80 mg/dL. Cytological evidence of malignancy in CSF was seen in 7 of 15 CPCs. Only CPCs had evidence of intraventricular or subarachnoid metastases on MRI.
Conclusions and Clinical Importance: MRI, CSF analysis or both can help to differentiate between CPPs and CPCs, and may provide valuable prognostic and pretreatment information.  相似文献   

8.
Objective— To report technique, surgical time, complication rate, and postoperative activity in dogs undergoing 2 intracorporeally-sutured total laparoscopic gastropexy (TLG) techniques compared with a laparoscopic-assisted gastropexy (LAG) technique.
Study Design— Randomized clinical trial.
Animals— Dogs (n=30) weighing >25 kg.
Methods— Dogs were randomly assigned to 1 of 3 groups. Two TLG techniques were performed using a median 3 portal technique. One of 2 suturing techniques was used to approximate corresponding incisions made in the stomach and body wall; using intracorporeal hand-suturing or a suture-assist device (Endostitch). In a 3rd group, a previously reported LAG technique was used. All dogs had an activity monitor placed for 7 days pre- and postoperatively. Linear regression analyses were performed to evaluate the association of surgical procedure on gastropexy time and the percentage change in activity counts.
Results— Median gastropexy time was 28 minutes (range, 20–41 minutes) for LAG, 48 minutes (range, 39–61 minutes) for the hand suture TLG technique, and 56 minutes (range, 30–90 minutes) for the Endostitch TLG technique. LAG was performed faster than TLG ( P <.05). LAG dogs had a greater decrease in postoperative activity than TLG dogs ( P =.005); however there was no difference in surgical time or postoperative activity between TLG techniques.
Conclusions— TLG can be performed safely and effectively in dogs and although it takes longer, it has less impact on postoperative activity compared with LAG.
Clinical Relevance— TLG techniques may have advantages over LAG as measured by a greater willingness of dogs to move around postoperatively.  相似文献   

9.
Background: Response and adverse reactions to combined gemcitabine (GEM) and carboplatin (CARBO) therapy in dogs with carcinomas are not documented.
Hypothesis: GEM and CARBO are safe for the treatment of dogs with carcinomas.
Animals: Thirty-seven dogs with histologically or cytologically confirmed carcinomas.
Methods: Prospective clinical trial. Dogs were treated with GEM (2 mg/kg, 20–30-minute infusion IV) on Days 1 and 8 and 4 hours later, CARBO (10 mg/kg IV) on Day 1. The cycle was repeated on Day 22.
Results: Thirty-seven dogs (29 with measurable tumor) received a median of 2 cycles (range 0.5–6) for a total of 101 cycles administered. Twelve dogs (32%) developed neutropenia (3 Grade 3, and 5 Grade 4) and 9 (24%) thrombocytopenia (2 Grade 3, and 1 Grade 4). Dogs >20 kg were twice as likely to develop thrombocytopenia ( P = .023). Twenty-seven dogs (73%) had evidence of gastrointestinal (GI) toxicosis, but most signs were of mild to moderate severity and self-limiting. One dog died of treatment-related complications. Overall tumor response rate was 13%. One dog with metastatic prostatic carcinoma achieved a complete remission and 1 dog with intestinal adenocarcinoma and 1 with tonsillar squamous cell carcinoma achieved partial remission. Twelve dogs achieved stable disease for a median of 72 days.
Conclusion and Clinical Importance: GEM and CARBO combination causes mild to moderate hematologic and GI toxicosis in dogs with carcinoma. Response rate in this study was modest, and optimization of dosing of this combination is required.  相似文献   

10.
Background: A liquid solution of levothyroxine (L-T4) is available for treatment of canine hypothyroidism.
Hypothesis: Once daily oral administration of a liquid L-T4 solution is effective and safe for controlling hypothyroidism in dogs.
Animals: Thirty-five dogs with naturally occurring hypothyroidism.
Methods: Dogs received L-T4 solution PO once daily at a starting dosage of 20 μg/kg body weight (BW). The dose was adjusted every 4 weeks, based on clinical signs and peak serum total T4 (tT4) concentrations. Target peak serum tT4 and thyroid stimulating hormone (TSH) concentrations, 4–6 hours posttreatment, were 35–95 nmol/L and < 0.68 ng/mL, respectively. Dogs were followed for up to 22 weeks after establishment of the maintenance dose.
Results: Clinical signs of hypothyroidism improved or resolved in 91% of dogs after 4 weeks of L-T4 treatment at 20 μg/kg once daily. The maintenance dose was established in 76, 94, and 100% of dogs after 4, 8, and 12 weeks of treatment, respectively. This was 20 μg L-T4/kg BW for 79% of the dogs, 30 μg/kg BW for 15%, and 10–15 μg/kg BW in the remaining 6%, once daily. Thereafter, median peak tT4 and TSH concentrations were 51 nmol/L and 0.18 ng/mL, respectively, and remained stable during the 22-week follow-up; clinical signs did not recur.
Conclusions and Clinical Importance: All of the hypothyroid dogs had rapid clinical and hormonal responses to supplementation with the PO-administered L-T4 solution. The starting dosage of 20 μg L-T4/kg BW once daily was suitable for 79% of dogs.  相似文献   

11.
Background: Although B-mode ultrasound is very sensitive for the detection of splenic lesions, its specificity is low. Contrast harmonic imaging is used successfully to differentiate benign from malignant liver lesions in humans and dogs.
Hypothesis: Contrast harmonic imaging could be useful to differentiate benign and malignant splenic lesions in dogs.
Animals: Sixty dogs (clinical patients) with splenic abnormalities detected during abdominal ultrasonography.
Methods: A prospective study was performed with a Philips ATL 5000 unit for contrast pulse inversion harmonic imaging (mechanical index: 0.08, contrast medium: SonoVue). Perfusion was assessed subjectively and quantitatively.
Results: Cytology or histology identified 27 benign (hyperplasia, extramedullary hematopoiesis, hematoma) and 29 malignant (hemangiosarcoma, malignant lymphoma, malignant histiocytosis, mesenchymal tumors without classification, mast cell tumors, and others) lesions and 4 normal spleens. Except for 1 benign nodule, extensive to moderate hypoechogenicity was only seen in malignant lesions during wash-in, at peak enhancement, and during wash-out ( P = .0001, odds ratios: 37.9 [95% CI 4.5–316.5], 66.4 [95% CI 8.0–551.1], and 36.9 [95% CI 4.4–308.4]). Although all but 1 benign lesion enhanced well and were mildly hypo-, iso-, or hyperechoic in comparison with the normal spleen during all blood pool phases, marked enhancement occurred both in benign as well as in malignant splenic lesions. Quantitative perfusion values did not differ significantly between benign and malignant lesions.
Conclusions and Clinical Importance: Moderate to extensive hypoechogenicity clearly identifies canine splenic malignant lesions. In nodules with marked enhancement, contrast harmonic ultrasound is of limited value and histology is needed.  相似文献   

12.
Background: Von Willebrand factor (vWF) antigen concentration, a marker of endothelial activation, is increased in human patients with multiorgan failure, sepsis, or both, and is an independent predictor of survival.
Hypothesis/Objectives: vWF antigen concentrations are significantly higher in dogs with sepsis.
Animals: Fourteen dogs hospitalized with sepsis. Sepsis was defined as microbiologic or cytologic evidence of infection combined with systemic inflammatory response syndrome. Control dogs were healthy dogs, without evidence of disease.
Methods: Prospective, observational study. Dogs admitted to the intensive care unit with a diagnosis of sepsis were considered eligible for enrollment into the study. Exclusion criteria included a previous diagnosis of von Willebrand disease or a recent history of a plasma transfusion. Citrated plasma samples were collected for analysis of vWF antigen by ELISA. All samples were drawn from dogs during hospitalization. Data between populations were analyzed using nonparametric statistical analysis with a P value < .05 considered significant.
Results: Twenty-five dogs were enrolled; 14 dogs with sepsis and 11 control dogs. The median vWF antigen concentration in dogs with sepsis was 156% (range, 117–200%), which was significantly higher than healthy dogs (105%; range, 44–155%, P < .005). There was no difference between survivors and nonsurvivors with a median vWF antigen concentration of 144% (range, 136–201%) in survivors (n = 7) and 159% (range, 122–174%) in nonsurvivors (n = 7) ( P = .5).
Conclusions and Clinical Importance: vWF is increased in dogs with sepsis, possibly reflecting endothelial activation. Further exploration of endothelial function is warranted in critically ill dogs.  相似文献   

13.
Objective— To compare the diagnostic yield of conventional radiographs and computed tomography (CT) images of the skulls of dogs and cats with maxillofacial trauma (MFT).
Study Design— Prospective study.
Animals— Dogs (n=9) and 15 cats with MFT.
Methods— CT-scans and skull radiographs (4 standard projections) for each animal were evaluated using a semi-quantitative scoring system for the ability to identify 26 predefined, clinically relevant anatomic features (Part 1), and 27 predetermined potential traumatic injuries (Part 2). For Part 1, mean scores for each anatomic feature were recorded for every view and imaging modality. For Part 2, studies were evaluated for the frequency of cases where each predetermined traumatic injury was identified.
Results— Part 1: On radiographs it was easy to identify 17 of 26 anatomic features whereas 6 features were very difficult or impossible to identify on any view. All structures were considered easy or very easy to identify on CT. Scores for CT were lower than radiographs for evaluating dental occlusion and the integrity of the mandibular body. Part 2: CT scans demonstrated 1.6 times more maxillofacial injuries for dogs and 2.0 times more for cats than conventional radiographs. The average number of MFT injuries per animal by radiographs and CT-scan was 4.8 and 7.6 in dogs, and 3.8 and 7.7 in cats, respectively.
Conclusion— CT is superior to conventional skull radiography for identification of anatomic structures and traumatic injuries in dogs and cats. Skull radiography is useful for visualizing the mandibular body and dental occlusion.
Clinical Relevance— CT allows for accurate assessment, diagnosis and treatment planning of MFT in dogs and cats.  相似文献   

14.
Background: Chronic hepatitis (CH) in dogs is common but little is known about factors associated with survival. Ascites is a well-recognized negative prognostic indicator in humans.
Hypothesis: Ascites is a negative prognostic indicator in CH in dogs.
Animals: Thirty-four dogs with histologically confirmed CH presented to 1 institution between 1996 and 2005.
Methods: Retrospective observational study. CH was diagnosed by histopathology of liver tissue according to the WSAVA criteria. Ascites was diagnosed by abdominal ultrasound. The association of ascites with survival from diagnosis or onset of owner-reported clinical signs until death from any cause or from liver disease was analyzed. Ascitic and nonascitic groups were further analyzed for differences in treatment and sex.
Results: Fourteen of 34 dogs had ascites. Survival from diagnosis to death from liver disease was 0.4 months (95% confidence interval [CI], 0.2–0.6) for ascitic dogs and 24.3 months (CI 11.4–37.1) for nonascitic dogs ( P < .001), and from onset of signs to death from liver disease was 2.0 months (CI 0.0–5.6) for ascitic dogs and 33.0 months (CI 8.6–57.4) for nonascitic dogs ( P = .0020). Diet and spironolactone use differed between groups.
Conclusions and Clinical Importance: Ascites is a significant negative prognostic indicator in dogs with CH. Veterinarians and owners can use this information to aid clinical decision making in affected dogs.  相似文献   

15.
Background: Pacemaker implantation is the treatment of choice for symptomatic bradyarrhythmias. In dogs, a single chamber system is commonly used. In human patients with high-grade 2nd- or 3rd-degree atrioventricular (AV) block, physiologic pacing is recommended, because it improves cardiac output, blood pressure, exercise tolerance, and quality of life. In dogs, this type of pacing is seldom used.
Hypothesis: The implantation of a dual chamber pacemaker in dogs with AV block is a feasible procedure for restoring AV synchrony.
Animals: Thirty-three privately owned dogs with high-grade 2nd- or 3rd-degree AV block were included.
Methods: Patient data of all dogs with AV block presented for pacemaker implantation between December 1997 and November 2004 were reviewed.
Results: Dual chamber pacemaker implantation with AV synchronous stimulation was successfully performed in 33/33 dogs (100%). In 9/33 (27%) major and in 12/33 (36%) minor complications were observed. Mean survival time for the patients discharged from hospital (n = 32) was 33.6 ± 20.4 months (range, 3.9–83.5 months).
Conclusion and Clinical Importance: Dual chamber pacing is a feasible procedure in dogs with 2nd- or 3rd-degree AV block and is not associated with a higher complication rate compared with single chamber pacemaker systems. A major advantage over ventricular demand pacemaker systems is the restoration of AV synchrony for a substantial period of time.  相似文献   

16.
Objective – To determine the utility of human intravenous immunoglobulin (hIVIG) for the initial treatment of canine immune-mediated hemolytic anemia (IMHA).
Design – Blinded, randomized, clinical trial.
Setting – Veterinary teaching hospital.
Animals – Twenty-eight, client-owned dogs with primary IMHA.
Interventions – At enrollment, after diagnosis of IMHA, dogs were randomly assigned to receive either hIVIG or placebo, in a blinded fashion. For the next 14 days, all dogs received glucocorticoids as the sole immunosuppressant agent. All dogs received low-molecular-weight heparin as an anticoagulant. D-dimer concentrations were evaluated at the beginning and end of the study protocol to monitor for thromboembolic complications.
Measurements and Main Results – Twenty-five of 28 dogs (89%) were discharged from the hospital. Thirteen of those received hIVIG and 12 received placebo. Twenty-four dogs (86%) were alive 14 days after enrollment, and of these 13 received hIVIG and 11 received placebo. D-dimer concentrations were elevated in 86% of all dogs at the time of diagnosis.
Conclusions – For initial treatment of dogs with IMHA, the addition of hIVIG to corticosteroid treatment did not improve initial response, nor did it shorten hospitalization.  相似文献   

17.
Introduction:  Many dogs with lymphoid tumors develop resistance to chemotherapy. As a mechanism of drug resistance in canine lymphoma, ATP‐dependent drug efflux by P‐glycoprotein was reported, however, inhibition of apoptosis mediated by P53 inactivation has not been investigated. In this study, we investigated the relationship between p53 gene mutation and clinical drug resistance in canine lymphoid tumors.
Methods:  Tumor specimens were obtained from 44 dogs with lymphoid tumors. Mutations of p53 gene at exon 4–8 of these tumor tissues were examined by PCR‐SSCP (single strand conformational polymorphism) analysis, followed by nucleotide sequencing of the abnormal bands. The cases were treated with UW‐Madison protocol, and its response was evaluated by the tumor size or the number of peripheral leukemic cells.
Results:  Of the 44 dogs, 15 dogs (34%) had p53 mutation, whereas 29 dogs (66%) were devoid of p53 mutation, before or during the chemotherapeutic protocol. Rate of good response (CR and PR) to chemotherapy was significantly lower in the dogs with p53 mutation (20%) than those without p53 mutation (55%)(p = 0.022). Median overall survival duration after examination of p53 mutation was significantly shorter in dogs with p53 mutation (101days) than those without p53 mutation (223days)(p = 0.008).
Conclusions:  Lymphoid tumors with p53 mutations were shown to have worse prognosis than those without p53 mutation.  相似文献   

18.
Objective: To estimate the relative accuracy of a thoracic focused assessment with sonography for trauma (TFAST) protocol for rapid diagnosis of pneumothorax (PTX) and other thoracic injury in traumatized dogs. Design: Prospective case series. Setting: Private veterinary emergency center. Animals: One hundred and forty‐five client‐owned dogs evaluated within 24‐hours of injury. Interventions: Thoracic focused assessment with sonography for trauma protocol. Measurements and Main Results: Traumatized dogs were evaluated with a conventional ultrasound (US) machine using a standardized 4‐point thoracic FAST protocol before thoracic radiography (CXR) and thoracocentesis. PTX was diagnosed by the absence of the ‘glide sign,’ defined as the lack of the normal dynamic interface between lung margins gliding along the thoracic wall during respiration. Concurrent thoracic trauma was diagnosed by the presence of pleural or pericardial fluid or the presence of a ‘step sign,’ defined as an abnormal glide sign. Accuracy of TFAST was calculated relative to CXR findings. Results: Overall sensitivity (Se), specificity (Sp), and accuracy of TFAST relative to CXR were 78.1% (95% CI; 61.5, 89.9), 93.4% (95% CI; 87.4, 97.1), and 90.0%, respectively. Se and Sp were higher in dogs with penetrating trauma (93.3%, 96.0%) and for the evaluator with the most clinical experience (95.2%, 96.0%); only Se between the most experienced compared with others was statistically significant (P<0.05). TFAST documented other concurrent thoracic injury. Median time for TFAST was 3 minutes. Conclusions and Clinical Relevance: TFAST has the potential to rapidly diagnose PTX and other thoracic injury and guide therapy, including potentially life‐saving interventions, in traumatized dogs.  相似文献   

19.
Background – There is a high mortality rate in patients with systemic inflammatory response syndrome (SIRS) or sepsis. Therefore, an early diagnosis and prognostic assessment is important for optimal therapeutic intervention. The objective of the study was to evaluate if baseline values and changes in serum C-reactive protein (CRP) might predict survival in dogs with SIRS and sepsis.
Design – Prospective study; July 2004 to July 2005.
Setting – Small Animal Clinic, Berlin, Clinic of Small Animal Medicine, Munich.
Animals – Sixty-one dogs.
Measurements and Main Results – For the CRP analysis blood was drawn on day 0, 1, and 2; CRP was measured using a commercial ELISA test kit. Thirteen dogs suffered from nonseptic SIRS and 48 dogs from sepsis. The 14-day survival rate was 61% (69% nonseptic SIRS, 58% sepsis). Serum CRP was higher in sick dogs compared with controls ( P <0.001). Over the 3-day period surviving dogs ( n =31) displayed a significantly greater decrease in CRP than nonsurvivors ( n =10) ( P =0.001). No correlation was found between the initial CRP concentrations and the survival rate. The changes in CRP corresponded to the survival rate ( P =0.01).
Conclusion – There was no significant relationship between the survival rate in dogs with nonseptic SIRS or sepsis and the initial serum CRP concentrations. There was a correlation between decreasing CRP concentrations and recovery from disease. However, the changes in CRP concentrations over a 3-day period correctly predicted survival in 94% of dogs and death in 30% of the dogs (false positive rate 22%).  相似文献   

20.
Background: The importance of blood lactate concentrations in dogs with intracranial disease has not been established, despite frequently observed hyperlactatemia in dogs undergoing general anesthesia for advanced imaging, surgery, or both.
Hypothesis: Blood lactate concentrations are elevated in anesthetized dogs with intracranial disease, compared with dogs with intervertebral disc disease (IVDD).
Animals: Eighty-five hospitalized dogs undergoing advanced imaging, surgery, or both for primary neurologic disease; 30 with intracranial disease; 55 with IVDD.
Methods: Retrospective study. Age, breed, neurologic diagnosis, time from anesthesia induction to measurement of blood lactate, blood lactate concentration under anesthesia, and concurrently measured heart rate, mean arterial pressure, PCV, arterial hemoglobin oxygen saturation, and arterial partial pressure of oxygen were included in a multivariable linear regression analysis.
Results: Dogs with meningioma (adjusted mean lactate 2.99 mmol/L, 95% CL 2.21–4.05, P < 0.0001) and hydrocephalus (adjusted mean lactate 1.5 mmol/L, 95% CL 0.99–2.27, P = 0.003) had higher blood lactate concentrations compared with dogs with IVDD (adjusted mean lactate 0.79 mmol/L, 95% CL 0.6–1.04). Only dogs with meningioma had clinically important hyperlactatemia (>2.5 mmol/L).
Conclusions: Prospective studies are warranted to determine the degree and clinical importance of high blood lactate concentrations in dogs with intracranial disease.  相似文献   

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