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1% (nine cases) in the 30 days after the index event. The final model included age ≥65 years (odds ratio [OR] 9.59, 95% confidence interval [CI] 3.48-26.45; p<0.001), oxygen saturation/fraction of inspired oxygen index ≤300 (OR 15.03, 95% CI 5.74-39.33; p<0.001), and point-of-care lactate≥4mmol/L (OR 7.68, 95% CI 2.88-20.45; p<0.001). The poisoning Early Warning Score was constructed from these three variables, and 1 point was assigned to each variable. The area under the curve of the score was 0.896 (95% CI 0.82-0.96; p<0.001).

The poisoning Early Warning Score may help in decision-making and promote early identification of high-risk patients with acute poisoning in the prehospital context.

The poisoning Early Warning Score may help in decision-making and promote early identification of high-risk patients with acute poisoning in the prehospital context.Odontoplasty (floating and occlusal equilibration) is the most commonly performed procedure in equine dentistry. From an anatomic perspective, an irregular occlusal surface, prominent cingula, transverse ridges, and enamel points all contribute to the function, form, and longevity of the equine cheek tooth. With limited reserve crown available and an average functional life range between 18 and 25 years, removal of tooth structure should be conservative. The authors consider a quality oral examination to be the most important dental procedure performed in the horse. AD-5584 cell line Individual tooth evaluation should lead to a specific diagnosis and treatment plan. Tooth odontoplasty should be site-specific.Computed tomography (CT) has revolutionized the veterinarian's ability to image the equine skull and led to improved diagnostic accuracy and clarity for surgical planning. The increased cost for this evaluation is offset by more accurate diagnosis and targeted therapy. As novel technology is developed that allows for increased availability of equine head, the price will continue to decrease and more examinations will be performed. New skills are needed for the veterinarian to accurately interpret this modality. This article reviews the normal CT appearance of the equine skull and presents examples and key features of several common diseases.Adjunct extraction techniques are used when the shape or integrity of the tooth, the shape or size of the patient's oral cavity, the location of the tooth, or the location of the proximal teeth prevents or complicates standard oral extraction. Techniques described and discussed include partial coronectomy, tooth sectioning, minimally invasive buccotomy, transbuccal screw extraction, and commissurotomy.Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a progressive, painful disease, affecting incisors, canines, and cheek teeth. Examination findings include gingival inflammation, gingival recession and/or hyperplasia, subgingival swelling, bulbous enlargement of teeth, associated periodontal disease, pathologic tooth fracture, and/or tooth mobility and loss. Current hypotheses include biomechanical stresses and secondary bacterial involvement. Early recognition allows case management, but it is a progressive disease. Owner education is crucial; horses with complete or multiple extractions have a favorable prognosis. Human oral and dental health may be affected by bisphosophonate use; long-term effects of these drugs are currently unknown in horses.The nasal conchal bullae (dorsal and ventral) are separate, air-filled structures within their respective dorsal and ventral nasal conchae. Computed tomography scans have assisted with the increasing diagnosis of empyema of the nasal conchae. This condition is usually associated with dental or sinus disease. Drainage of affected bullae is considered critical for resolution of clinical signs. The ventral conchal bullae can be easily viewed with a standard 10 mm diameter flexible endoscopy via the middle nasal meatus. This approach can also be used for fenestration of the bullae, using a diode laser, equine laryngeal forceps, or bipolar vessel sealing device.Oral endoscopy is a valuable addition to the equine dental examination process. It enables veterinarians to visualize subtle oral disorders and is a useful client education tool. There are several commercially available oral endoscopic systems on the market. Practitioners can also assemble their own systems. An oral endoscope is used to perform a thorough and systematic oral examination and to visualize normal oral structures as well as oral disorders. It is also used to guide instrument placement during oral surgeries and other dental procedures.The anatomy of the equine paranasal sinuses is critical to understand to assess the extent of the disease process, the optimal surgical approach, and the ability to drain through the normal nasomaxillary pathway. By following established anatomic landmarks, direct sinus access can be used to further explore the sinus compartments, remove compromised cheek teeth, remove any purulent debris or feed contamination, and establish drainage. Many complications can be avoided or minimized by thoroughly evaluating all sinus compartments and critically assessing the ability of the sinus to drain.Radiography is an important imaging modality and is available to most equine veterinarians providing primary care. Diagnostic radiographic imaging of the equine skull and dentition requires careful positioning and technique. This article is aimed at providing the veterinarian with instructions and guidelines for obtaining diagnostic skull and dental radiographs and a discussion of the radiographic signs of dental disease with case-based examples. The limitations of radiography are discussed with regard to determining the need for adjunct diagnostic techniques and more advanced imaging techniques, such as computed tomography.

Iron deficiency anemia (IDA) is a medical comorbidity commonly diagnosed in those undergoing primary total hip arthroplasty (THA). The authors sought to evaluate IDA as a risk factor for early postoperative complications following discharge and describe the hospital resource utilization of this patient population.

Patients with a diagnosis of IDA who underwent THA from 2005 to 2014 were identified in a national insurance database. The rates of postoperative medical complications and surgery-related complications, as well as hospital readmission, emergency department visits, and death were calculated. Additionally, 90-day and day of surgery cost and length of stay were calculated. IDA patients were then compared to a 41 matched control population without IDA using a logistic regression analysis to control for confounding factors.

In total, 98,681 patients with a preoperative diagnosis of IDA who underwent THA were identified and compared to 386,724 controls. IDA was associated with increased risk of 30-day emergency department visits (odds ratio [OR] 1.

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