Postoperative regurgitation in dogs after upper airway surgery to treat brachycephalic obstructive airway syndrome: 258 cases (2013-2017).
犬上气道手术治疗短头阻塞性气道综合征术后反流 258 例 (2013-2017)。
- 作者列表："Fenner JVH","Quinn RJ","Demetriou JL
OBJECTIVE:To determine the incidence of and risk factors for regurgitation in dogs within 24 hours of surgical management of brachycephalic obstructive airway syndrome (BOAS). STUDY DESIGN:Retrospective single center study of dogs undergoing BOAS surgery over four years (2013-2017). ANIMALS:Two hundred fifty-eight client-owned dogs referred for surgical intervention for BOAS. METHODS:Electronic medical records were searched for dogs that had undergone surgery for BOAS at a UK specialist referral hospital. Data were assessed by using univariable binomial logistic regression; confounding factors were then identified in a multivariable model. RESULTS:There was an increase in the proportion of dogs that regurgitated while hospitalized preoperatively vs during the first 24 hours postoperatively, from 28 (10.9%) to 89 (34.5%), respectively (P < .0001). History of regurgitation (P = .017, odds ratio [OR] 2.539, 95% confidence interval [CI] 1.178-5.469) and age (P = .008, OR 0.712, 95% CI 0.553-0.916) were detected as risk factors for postoperative regurgitation. For every 1-year increase in age, the odds of experiencing postoperative regurgitation were reduced by 28.8%. CONCLUSION:Corrective surgery for BOAS was associated with a marked incidence of postoperative regurgitation. Younger dogs and those with a history of regurgitation were predisposed to postoperative regurgitation. CLINICAL SIGNIFICANCE:The increased frequency of regurgitation after surgical treatment of BOAS, especially in younger dogs, provides justification for counseling owners regarding this postoperative complication.
目的: 探讨犬短头阻塞气道综合征 (BOAS) 手术治疗后 24 h内反流的发生率及危险因素。 研究设计: 四年内接受BOAS手术的犬的回顾性单中心研究 (2013-2017)。 动物: 200 条客户拥有的狗被转介为BOAS进行手术干预。 方法: 在英国一家专科转诊医院对接受BOAS手术的犬进行电子病历检索。使用单变量二项logistic回归评估数据; 然后在多变量模型中确定混杂因素。 结果: 术前住院时反刍犬的比例高于术后 24 小时，从 28 只 (10.9%) 增加到 89 只 (34.5%)，分别 (p <.0001)。反流史 (P =。017，比值比 [OR] 2.539，95% 可信区间 [CI] 1.178-5.469) 和年龄 (P = .008，OR 0.712，95% CI 0.553-0.916) 被检测为术后反流的危险因素。年龄每增加 1 年，发生术后反流的几率降低 28.8%。 结论: BOAS的矫正手术与术后反流的发生率显著相关。年轻犬和有反流史的犬易患术后反流。 临床意义: BOAS手术治疗后反流频率增加，尤其是年轻犬，为咨询业主关于这种术后并发症提供了理由。
METHODS::Impairments in social cognition have been frequently described in 22q11.2 deletion syndrome (22q11.2DS) and are thought to be a hallmark of difficulties in social interactions. The present study addresses aspects that are critical for everyday social cognitive functioning but have received little attention so far. Sixteen children with 22q11.2DS and 22 controls completed 1 task of facial expression recognition, 1 task of attribution of facial expressions to faceless characters involved in visually presented social interactions, and 1 task of attribution of facial expressions to characters involved in aurally presented dialogues. All three tasks have in common to involve processing of emotions. All participants also completed two tasks of attention and two tasks of visual spatial perception, and their parents completed some scales regarding behavioural problems of their children. Patients performed worse than controls in all three tasks of emotion processing, and even worse in the second and third tasks. However, they performed above chance level in all three tasks, and the results were independent of IQ, age and gender. The analysis of error patterns suggests that patients tend to coarsely categorize situations as either attractive or repulsive and also that they have difficulties in differentiating emotions that are associated with threats. An isolated association between the tasks of emotion and behaviour was found, showing that the more frequently patients with 22q11.2DS perceive happiness where there is not, the less they exhibit aggressive behaviour.
METHODS:BACKGROUND:We describe the first radiographic clinic in the literature for DDH and how this novel clinic can significantly improve the efficiency and cost-effectiveness of service in a tertiary referral centre. AIMS:A radiographic clinic for the management of developmental dysplasia of the hip was introduced in 2017 in our institution. We performed a detailed cost analysis to assess the economic savings made with the introduction of this new clinic. We assessed the efficiency of the service by identifying how many unnecessary outpatient visits were prevented. We also assessed the difference in times from referral to review between the two clinics. METHODS:Analysis of the clinic activity in 2017 was possible as all data was collected prospectively by the DDH CNS and stored in our database. Cost analysis was performed, and the savings made per patient along with the financial benefit to our institution was recorded. RESULTS:The new radiographic clinic reduced the cost of reviewing one patient by €162.51 per patient. There was a 73% discharge rate from the clinic which prevented 251 unnecessary patient visits to the outpatient department over the course of the year. There was a significant 11-day reduction in waiting times between referral and review when comparing the radiographic to the conventional clinic (p < 0.05). CONCLUSIONS:A radiographic clinic for the management of developmental dysplasia of the hip has a significant effect on the efficiency and overall cost-effectiveness of service provision in a tertiary referral centre.
METHODS:INTRODUCTION:Triple pelvic osteotomy (TPO) involves periacetabular osteotomies of the ilium, ischium, and pubis to reorient the acetabulum. This operation is indicated in certain situations for the treatment of developmental dysplasia of the hip, dysplastic neuromuscular hips, and for containment of the femoral head in cases of Legg-Calvé-Perthes disease. METHODS:This retrospective cohort study compares radiographic outcomes of patients who underwent TPO using two different techniques and describes a novel single-incision direct lateral approach. TPO was performed on 22 patients by the senior author. The first 10 patients underwent TPO through a single-incision anterolateral approach. The last 12 patients underwent TPO using the direct lateral approach. Preoperative and postoperative pelvic radiographs were reviewed for each patient, and the migration index and center-edge angle were recorded. RESULTS:The migration index and center-edge angle were evaluated and were not found to be significantly different between the anterolateral and direct lateral groups. The direct lateral approach is described. CONCLUSION:The direct lateral approach for TPO is equivalent to the anterolateral approach on radiographic evaluation. Advantages of the direct lateral approach include direct visualization of the ischial osteotomy, effective mobilization of the acetabulum, and safety of the sciatic nerve.