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Various Diagnostic (various + diagnostic)

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Medical Sciences	100%

Selected Abstracts

Clinical application of continuous spirometry with a pitot-based flow meter during equine anaesthesia

EQUINE VETERINARY EDUCATION, Issue 7 2010
Y. P. S. Moens
Summary This report documents the feasibility and clinical information provided by a new method for spirometric monitoring adapted for equine anaesthesia. Monitoring of ventilatory function was done with continuous spirometry during general anaesthesia of client-owned horses presented for various diagnostic and surgical procedures. An anaesthetic monitor with a spirometry unit for human anaesthesia was used. To allow the measurement of large tidal volumes, a remodelled larger version of the pitot tube- based flow sensor was used. This technology provided reliable spirometric data even during prolonged anaesthesia when water condensation accumulated in the anaesthetic circuit and the sensor. In addition to flow and volume measurement and respiratory gas analysis, the continuous display of flow-volume and pressure-volume loops offered visually recognisable information about compliance, airway resistance and integrity of the circuit. Continuous spirometry with this monitoring system was helpful in evaluating the efficacy of spontaneous ventilation, in adjusting intermittent positive pressure ventilation and detecting technical faults in the anaesthetic apparatus and connection with the patient. This adapted spirometry method represents a practical and reliable measuring system for use during equine anaesthesia. The variety of information provides an opportunity to optimise anaesthetic management in this species. [source]

Clinical evaluation of a new formulation of propofol in a medium-chain and long-chain triglycerides emulsion in dogs

JOURNAL OF VETERINARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2007
J. I. REDONDO GARCÍA
Propofol formulated in a mixed medium-chain and long-chain triglycerides emulsion has been recently introduced for clinical use as an alternative to the conventional long-chain triglycerides formulation. This prospective multicentric study evaluated the clinical effectiveness and the complications associated with the use of this new formulation of propofol in dogs. Forty-six Spanish veterinary clinics participated in this study. A total of 541 anaesthesias (118 ASA I, 290 ASA II, 101 ASA III and 32 ASA IV) performed for various diagnostic and therapeutic purposes were evaluated. The anaesthetic protocol was not controlled, with the exception that propofol had to be used at least for induction of anaesthesia. The induction dose of propofol and the incidence of anaesthetic complications throughout the procedure were recorded. A chi-square test compared the incidence of complications according to the maintenance agent used (propofol vs. inhalatory anaesthesia), anaesthetic risk (ASA classification) and the reason for the anaesthesia. The patients premedicated with ,2 agonists needed lower doses (mean ± SD, 2.9 ± 1.3 mg/kg i.v.) than the animals premedicated with phenothiazines (3.9 ± 1.4 mg/kg i.v.) or benzodiazepines (4.0 ± 1.4 mg/kg i.v.). The most frequent complications were difficult endotracheal intubation (1.3%), postinduction apnoea (11.3%), cyanosis (0.6%), bradypnoea (2.6%), tachypnoea (2.8%), bradycardia (2%), tachycardia (2.6%), hypotension (0.2%), shock (0.2%), vomiting (4.6%), epileptiform seizures (2.8%), premature awakening (7.4%) and delayed recovery (0.9%). There were no cases of pain on injection or aspiration pneumonia. Three dogs died (0.55%), one during induction and two during recovery from anaesthesia. This study demonstrates that the new formulation of propofol is an useful and effective drug to induce general anaesthesia in dogs. [source]

Iatrogenic vertebral artery injury

ACTA NEUROLOGICA SCANDINAVICA, Issue 6 2005
J. Inamasu
Iatrogenic vertebral artery injury (VAI) results from various diagnostic and therapeutic procedures. The objective of this article is to provide an update on the mechanism of injury and management of this potentially devastating complication. A literature search was conducted using PubMed. The iatrogenic VAIs were categorized according to each diagnostic or therapeutic procedure responsible for the injury, i.e., central venous catheterization, cervical spine surgery, chiropractic manipulation, diagnostic cerebral angiography, percutaneous nerve block, and radiation therapy. The incidence, mechanisms of injury, and reparative procedures were discussed for each type of procedure. The type of VAI depends largely on the type of procedure. Laceration was the dominant type of acute injury in central venous catheterization and cervical spine surgery. Arteriovenous fistulae and pseudoaneurysms were the delayed complications. Arterial dissection was the dominant injury type in chiropractic manipulation and diagnostic cerebral angiography. Inadvertent arterial injection caused seizures or stroke in percutaneous nerve block. Radiation therapy was responsible for endothelial injury which in turn resulted in delayed stenosis and occlusion of the vertebral artery (VA). The proximal VA was the most vulnerable portion of the artery. Although iatrogenic VAIs are rare, they may actually be more prevalent than had previously been thought. Diagnosis of iatrogenic VAI may not always be easy because of its rarity and deep location, and a high level of suspicion is necessary for its early detection. A precise knowledge of the surgical anatomy of the VA is essential prior to each procedure to prevent its iatrogenic injury. [source]

4344: Sixth nerve palsy: who needs a workup, who needs a scan?

ACTA OPHTHALMOLOGICA, Issue 2010
V PURVIN
Purpose To aid the clinician in the management of patients with sixth nerve palsy. Methods The yield of various diagnostic for sixth nerve and other cranial nerve palsies will be reviewed. Attention will focus on risk factors that predict a positive result on diagnostic testing, particularly neuroimaging. Results Most patients can be assigned a relative risk of harboring an underlying disease as the cause of their sixth nerve palsy but some will be missed. In most cases, a delayed diagnosis does not alter the outcome. Conclusion The decision whether to image a patient with a sixth nerve palsy remains controversial and must be individualized. [source]