Hermansenratliff7380

An 11-year-old castrated male Vizsla was evaluated for excision of a cranial mediastinal mass.

The dog had a 1-month history of a cough that had recently increased in frequency. On physical examination, the dog had a grade 2/6 left systolic heart murmur and multiple subcutaneous masses. A soft tissue mass was observed in the cranioventral aspect of the thorax on radiographs. Results of a CT scan revealed a well-defined, 2.8 × 3.2 × 3.9-cm soft tissue mass in the cranial mediastinum.

The dog underwent video-assisted thoracoscopic removal of the mediastinal mass and recovered routinely. Histologic examination of excised tissues revealed malignant thymoma. Approximately 6.5 months after surgery, the dog was evaluated because of polyuria, polydipsia, decreased appetite, and vomiting. Selleckchem Tanespimycin On physical examination, masses were found in both axillary regions. Results of serum biochemical analysis indicated hypercalcemia. Thoracic ultrasonography revealed pulmonary metastases and a large mass in the right caudoventrsuch as those in the patient of this report.

To evaluate outcomes of dogs and owner satisfaction and perception of their dogs' adaptation following amputation of a thoracic or pelvic limb.

Retrospective case series.

64 client-owned dogs. Procedures-Medical records of dogs that underwent limb amputation at a veterinary teaching hospital between 2005 and 2012 were reviewed. Signalment, body weight, and body condition scores at the time of amputation, dates of amputation and discharge from the hospital, whether a thoracic or pelvic limb was amputated, and reason for amputation were recorded. Histologic diagnosis and date of death were recorded if applicable. Owners were interviewed by telephone about their experience and interpretation of the dog's adaptation after surgery. Associations between perioperative variables and postoperative quality of life scores were investigated.

58 of 64 (91%) owners perceived no change in their dog's attitude after amputation; 56 (88%) reported complete or nearly complete return to preamputation quality of life, 50 (78%) indicated the dog's recovery and adaptation were better than expected, and 47 (73%) reported no change in the dog's recreational activities. Body condition scores and body weight at the time of amputation were negatively correlated with quality of life scores after surgery. Taking all factors into account, most (55/64 [86%]) respondents reported they would make the same decision regarding amputation again, and 4 (6%) indicated they would not; 5 (8%) were unsure.

This information may aid veterinarians in educating clients about adaptation potential of dogs following limb amputation and the need for postoperative weight control in such patients.

This information may aid veterinarians in educating clients about adaptation potential of dogs following limb amputation and the need for postoperative weight control in such patients.

To characterize clinical and pathological features of implant-associated neoplasms in dogs.

Retrospective case-control study.

16 dogs with implant-associated neoplasia and 32 control dogs with osteosarcoma without implants. Procedures Medical records of dogs with tumors associated with metallic implants (cases) treated between 1983 and 2013 were reviewed. Two dogs with naturally occurring osteosarcoma (controls) were matched to each case on the basis of tumor location, age, and sex.

Median time from implant placement to diagnosis of neoplasia was 5.5 years (range, 9 months to 10 years). Pelvic limbs were most frequently affected, including the tibia (8/16) and femur (5/16), with 1 neoplasm involving both the femur and pelvis. Implant associated tumors most commonly affected the diaphysis (15/16), with osteosarcomas significantly more likely to involve the long bone diaphysis in case dogs than in control dogs with naturally occurring osteosarcomas. Osteosarcoma was the most common tumor, accounting for 13 of 16 implant-associated tumors. For 7 of these osteosarcoma cases, review of histopathology results enabled subclassification into osteoblastic nonproductive (n = 3), chondroblastic (2), osteoblastic productive (1), and fibroblastic (1) groups. Three case dogs had a diagnosis of histiocytic sarcoma, fibrosarcoma, and spindle cell sarcoma.

Results of this study highlighted important anatomic differences between spontaneous and implant-associated neoplasia in dogs.

Results of this study highlighted important anatomic differences between spontaneous and implant-associated neoplasia in dogs.

To describe outcomes for dogs with primary hyperparathyroidism following treatment with percutaneous ultrasound-guided ethanol ablation of presumed functional parathyroid nodules.

Retrospective case series.

24 dogs with primary hyperparathyroidism that underwent 27 ultrasound-guided ethanol ablation procedures of presumed functional parathyroid nodules identified by cervical ultrasonography.

Dogs were anesthetized for each procedure. For each nodule, 95% ethanol was injected into the center with ultrasound guidance (volume injected calculated on the basis of ultrasonographic measurements). The interval from treatment to resolution of hypercalcemia, complications, and follow-up clinicopathologic data were recorded.

5 procedures involved simultaneous treatment of 2 nodules. Three dogs underwent a second treatment because of initial treatment failure or development of another nodule. Hypercalcemia resolved after 23 of 27 (85%) procedures. In those 23 treatments, 22 (96%) had resolution of hypercalcemiaimal complications, and low risk for hypocalcemia.

To investigate whether prewarming affects body temperature of small dogs (weighing < 10 kg [22 lb]) undergoing inhalation anesthesia.

Prospective, randomized, blinded clinical trial. Animals 20 dogs weighing < 10 kg with American Society of Anesthesiologists physical status I or II.

Baseline rectal temperature was recorded. Before IM administration of buprenorphine hydrochloride and acepromazine maleate, dogs were randomly assigned to be placed in a pediatric incubator at 33°C (91.4°F) for approximately 30 to 60 minutes (prewarming group) or to receive no prewarming (control group); subsequently, dogs underwent inhalation anesthesia with isoflurane in oxygen. Rectal, esophageal, and ambient temperatures were measured every 5 minutes from induction of anesthesia (IOA) for > 1 hour by an observer who was unaware of treatment. If a dog became hypothermic (esophageal temperature < 36°C [96.8°F]), it was withdrawn from the study. Variables of interest relating to dogs, anesthesia, temperatures, hypothermia, and study withdrawal were compared between groups.

1 dog was excluded from the prewarming group after becoming excessively excited in the incubator. Between groups, age, weight, body condition score, degree of preanesthesia sedation, interval from sedation to IOA, duration of anesthesia, baseline rectal temperature, rectal temperatures immediately prior to IOA, esophageal temperature following IOA, ambient temperature during the first 70 minutes of anesthesia, esophageal or rectal temperature during the first 90 minutes of anesthesia, and incidence of hypothermia and study withdrawal (5 dogs/group) did not differ significantly.

Prewarming in an incubator prior to IOA failed to improve or maintain body temperature of dogs weighing < 10 kg during inhalation anesthesia.

Prewarming in an incubator prior to IOA failed to improve or maintain body temperature of dogs weighing less then 10 kg during inhalation anesthesia.

Workplace alcohol policies are crucial for workers' health and safety. The practice of outsourcing is gaining popularity around the world and was found to be associated with poorer health in the working population. This study aimed to examine how outsourcing complicates the implementation of workplace alcohol policies and affects workers' drinking behaviors.

In-depth interviews were conducted with 16 outsource workers, 3 subcontractors and 3 worksite supervisors. Information regarding workers' drinking behaviors, their knowledge, and attitudes toward workplace alcohol policy were analyzed using a qualitative thematic analysis.

Factors associated with poor workplace alcohol management included smaller size and private ownership of outsourcers, subcontractors' own drinking behavior and positive attitude to alcohol, and precarious employment conditions of outsourcing workers. The multilateral relationship between outsourcers, subcontractors, and workers complicated and impaired the implementation of workplace alcohol policies.

The implementation of workplace alcohol management policies was hampered in outsourcing work conditions due to poor coordination of supervisors in the subcontract chain. The enforcement of alcohol policies in the workplace should be strengthened by consolidating management responsibilities of outsourcers and subcontractors.

The implementation of workplace alcohol management policies was hampered in outsourcing work conditions due to poor coordination of supervisors in the subcontract chain. The enforcement of alcohol policies in the workplace should be strengthened by consolidating management responsibilities of outsourcers and subcontractors.POEMS syndrome is a rare plasma cell dyscrasia. Serum concentrations of the monoclonal protein in this disorder are typically low, and inapplicable to monitor disease activity in most cases, resulting in limited practical and prognostic values. Novel immunoassays measuring isotype-specific heavy/light chain (HLC) pairs showed its utility in disease monitoring and outcome prediction in several plasma cell dyscrasias. We report results of HLC measurements in 90 patients with POEMS syndrome. Sixty-six patients (73%; 95% confidence interval, 63-82%) had an abnormal HLC ratio at baseline. It could stratify the risk of disease relapse and was strongly associated with worse progression-free survival in a multivariate analysis (P = 0.021; hazard ratio [HR] 6.89, 95% CI 1.34-35.43). After therapy, HLC ratios improved, with 43 patients (48%) remaining abnormal. The post-therapeutic HLC ratio, if abnormal, also remained as an independent prognostic factor associated with worse progression-free survival (P = 0.019; HR 4.30, 95% CI 1.27-14.56). These results suggest the prognostic utility of HLC ratios in clinical management of POEMS patients.

This protocol describes a systematic review that evaluates the effects of physician substitution by mid-level providers (nurse practitioners, physician assistants or nurses) in primary healthcare for older people and long-term care facilities. The secondary aim is to describe facilitators and barriers to the implementation of physician substitution in these settings.

Healthcare for older people is undergoing major changes, due to population ageing and reforms that shift care to the community. Besides, relatively few medical students are pursuing careers in healthcare for older people. Innovative solutions are needed to guarantee the quality of healthcare and to contain costs. A solution might be shifting care from physicians to mid-level providers. To date, no systematic review on this topic exits to guide policymaking.

A quantitative systematic literature review using Cochrane methods.

The following databases will be searched for original research studies that quantitatively compare care provided by a physician to the same care provided by a mid-level provider PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL and Web of Science.