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Open Veterinary Journal Feb 2024Camels are subjected to a wide variety of nutritional deficiencies as they are largely dependent upon grazing desert plants. As a consequence, the syndrome of pica or...
BACKGROUND
Camels are subjected to a wide variety of nutritional deficiencies as they are largely dependent upon grazing desert plants. As a consequence, the syndrome of pica or depraved appetite is occasionally seen in dromedary camels. The condition is manifested as chewing or eating abnormal things such as wood, dirt, bones, stones, clothes, plastics, mud, sand, or other inanimate objects.
AIM
This study was designed to investigate the clinical, ultrasonographic, and postmortem findings in dromedary camels with pica or depraved appetite.
METHODS
Twenty-five camels of 5 days to 15 years were examined. Owner complaints included depraved appetite, loss of body condition, regurgitation of stomach content, and partial or complete absence of feces. Symptoms described were present for a period varying between 3 days, up to 12 months. The stomach compartments and small and large intestines were scanned using ultrasonography from the right and left sides of the abdomen. Necropsy was carried out on six female and three male camels where the thoracic and abdominal organs were examined with special attention to the digestive system.
RESULTS
The affected animals had a history of gradual loss of body conditions, eating foreign objects, decreased or total absence of feces, and regurgitation of stomach content. Using ultrasound, the foreign body was imaged occluding completely or partially the intestines. Foreign bodies within the rumen could not be visualized with ultrasound. In cases where the rumen is impacted by sand, small pin-points revealing acoustic enhancement were imaged. Foreign bodies were removed from the rumen at exploratory rumenotomy ( = 11), laparotomy ( = 3), or at necropsy ( = 8) in the form of plastics, cloths, sand, mud, wool balls, robes, glasses, or even metallic objects which may be blunt or sharp. Sixteen (64%) of the camels were recovered while the remaining 9 (36%) did not survive.
CONCLUSION
The syndrome of pica or depraved appetite is an important condition in dromedary resulting in the ingestion of objects other than normal feed. Substantial economic losses are expected as a result of this syndrome. Ultrasonography of the digestive system may help the clinician in some cases to localize of occluding foreign bodies in the intestines, while in the transabdominal scanning of the stomach is valuable only in cases of sand impaction.
Topics: Animals; Camelus; Appetite; Pica; Sand; Foreign Bodies
PubMed: 38549572
DOI: 10.5455/OVJ.2024.v14.i2.5 -
Journal of Cerebrovascular and... Mar 2024Percutaneous techniques for femoral arterial access are increasingly being performed due to advances in endovascular cerebral procedures, as they provide a less morbid...
Percutaneous techniques for femoral arterial access are increasingly being performed due to advances in endovascular cerebral procedures, as they provide a less morbid and minimally invasive approach than open procedures. Common complications associated with this peripheral puncture include hematoma, bleeding, pseudoaneurysm, arteriovenous fistula, retroperitoneal bleeding, inadvertent venous puncture, dissection, etc. The retrograde femoral access is currently the most frequently used arterial access as it is technically straightforward, allows for the use of larger size sheaths and catheters, allows repeated attempts, etc. Although being technically less challenging, grave complications can occur due to hardware failure. Here, we present a case of unruptured posterior inferior cerebellar artery (PICA) aneurysm, who underwent uneventful diagnostic cerebral digital substraction angiography (DSA) via right femoral artery route on first attempt, but on second attempt for therapeutic intervention, landed up with stuck guide wire and faced decannulation difficulty due to unravelling of guide wire and multiple knot formation, which was finally removed after multiple attempts at pulling and improvised manoeuvres. Such cannulation and decannulation difficulties have been reported multiple times for central venous access, but extremely rarely for femoral routes, making this case a rarity and worth reporting.
PubMed: 38528441
DOI: 10.7461/jcen.2024.E2023.06.002 -
Reumatismo Mar 2024To report cross-sectionally serum levels of 25-hydroxyvitamin D [25(OH)D] in women living in Italy within 12 months from breast cancer (BC) diagnosis. (Clinical Trial)
Clinical Trial
OBJECTIVE
To report cross-sectionally serum levels of 25-hydroxyvitamin D [25(OH)D] in women living in Italy within 12 months from breast cancer (BC) diagnosis.
METHODS
Baseline data were obtained from 394 women diagnosed with primary BC, enrolled from 2016 to 2019 in a lifestyle trial conducted in Italy. Subjects' characteristics were compared between two 25(OH)D concentrations (hypovitaminosis D<20 and ≥20 ng/mL) with the Chi-squared test or Fisher's exact test for small-expected counts. Using multiple logistic regression-adjusted models, we estimated odds ratios (ORs) of hypovitaminosis D with 95% confidence intervals (CIs) in the total sample and in the unsupplemented subgroup.
RESULTS
Hypovitaminosis D was found in 39% of all subjects, 60% in unsupplemented subjects, and 10% in supplemented subjects. Increasing ORs of hypovitaminosis D were found with increasing body mass index, 25-30, >30, and ≥35 versus <25 kg/m2 (ORs: 2.50, 4.64, and 5.81, respectively, in the total cohort and ORs: 2.68, 5.38, and 7.08 in the unsupplemented); living in the most southern Italian region (OR 2.50, 95%CI 1.22-5.13); and with hypertriglyceridemia (OR 2.46; 95%CI 1.16-5.22), chemotherapy history (OR 1.86, 95%CI 1.03-3.38), and inversely with anti-estrogenic therapy (OR 0.43, 95%CI 0.24-0.75) in the total sample.
CONCLUSIONS
Hypovitaminosis D in women recently diagnosed with BC and participating in a lifestyle trial in Italy was widespread and highest with obesity, hypertriglyceridemia, and chemotherapy use. Considering that hypovitaminosis D is a risk factor for lower efficacy of bone density treatments and possibly BC mortality, our results suggest the need to promptly address and treat vitamin D deficiency.
Topics: Female; Humans; Breast Neoplasms; Hypertriglyceridemia; Italy; Life Style; Risk Factors; Vitamin D; Vitamin D Deficiency
PubMed: 38523582
DOI: 10.4081/reumatismo.2024.1632 -
World Neurosurgery: X Jul 2024The fluorescein videoangiography (FL-VAG) has become a valuable adjunct tool in vascular neurosurgery. This work describes using the FL-VAG during bypass surgery and...
BACKGROUND
The fluorescein videoangiography (FL-VAG) has become a valuable adjunct tool in vascular neurosurgery. This work describes using the FL-VAG during bypass surgery and proposes a classification method for evaluating surgical results.
METHODS
We analyzed 26 patients with 50 cerebral bypasses from September 2018 to September 2022. We used a three grades classification method based on the pass of intravenous fluorescein through the anastomosis. Grade 1 represents the synchronous and total filling of the "T" shape ("green T″) formed by the donor and recipient vessel, Grade 2, the asynchronous filling of the anastomosis (incomplete/asynchronous "green T″), and Grade 3, a non-patent anastomosis (absence of "green T″).
RESULTS
Of the 26 patients, 8 underwent one bypass, 14 underwent double bypass, 2 underwent three bypasses, and 2 underwent four bypasses in two different interventions. The type of bypass was end-to-side anastomosis in 47 (94%) cases, internal maxillary artery to middle cerebral artery bypass with a radial artery graft (IMax-MCA anastomosis) in 2 (4%), and PICA-VA transposition in one (2%). We made 24 (48%) bypasses on the right side and 26 (52%) on the left side. After the initial surgery, thirty-nine (78%) bypasses were considered as Grade 1, 5 (10%) as Grade 2, and 6 (12%) as Grade 3. After intraoperative bypass patency assessment (IBPA), 45 (90%) of the bypasses were considered Grade 1 and remained patent on CTA.
CONCLUSIONS
Using FL-VAG and a three-tier classification method is a reliable tool to predict bypass patency. It is safe, low-risk, and available worldwide.
PubMed: 38516026
DOI: 10.1016/j.wnsx.2024.100287 -
Frontiers in Neurology 2024Accurate and timely diagnosis of posterior circulation stroke in patients with acute dizziness is a challenge that can lead to misdiagnosis and significant harm. The... (Review)
Review
Accurate and timely diagnosis of posterior circulation stroke in patients with acute dizziness is a challenge that can lead to misdiagnosis and significant harm. The present review sought to identify and describe published research on the clinical application of vHIT in posterior circulation stroke. vHIT, a portable device, has gained prominence in evaluating peripheral vestibular disorders and offers potential applications in diagnosing neurological disorders, particularly posterior circulation stroke. Several studies have shown that vHIT can differentiate between stroke and vestibular neuritis based on VOR gain values, with high sensitivity and specificity. The manuscript also discusses vHIT's performance in differentiating between types of posterior circulation stroke, such as PICA, AICA, and SCA strokes. While vHIT has demonstrated promise, the review emphasizes the need for further research to validate its use as a tool to rule out stroke in acute dizziness patients in the emergency department. In conclusion, the manuscript underscores the potential of vHIT as a valuable addition to the diagnostic arsenal for acute dizziness, particularly in the context of posterior circulation stroke. It calls for further research and wider adoption of vHIT in clinical settings to improve patient care and reduce unnecessary costs associated with misdiagnoses.
PubMed: 38497038
DOI: 10.3389/fneur.2024.1339039 -
Cureus Feb 2024In this case, a 61-year-old patient presented with Horner's syndrome of the left eye, left-sided truncal ataxia, left-sided pain/paresthesia of the face as well as...
In this case, a 61-year-old patient presented with Horner's syndrome of the left eye, left-sided truncal ataxia, left-sided pain/paresthesia of the face as well as right-sided loss of pain and temperature of the arms and legs. MRI findings displayed a clear 4 mm acute left lateral medullary infarct of the left posterior inferior cerebellar artery (PICA) vascular territory, indicative of lateral medullary syndrome (LMS). The presence of pre-existing medical conditions such as uncontrolled diabetes, late-stage syphilis, and a mechanical aortic valve complicated this clinical picture. The presence of ipsilateral corticospinal deficits in this patient revealed Opalski syndrome, a rare variant of LMS. This case report highlighted the importance of correlating imaging and physical examination of stroke findings.
PubMed: 38496203
DOI: 10.7759/cureus.54314 -
Acta Neurochirurgica Mar 2024Neurovascular compression of the rostral ventrolateral medulla (RVLM) has been described as a possible cause of refractory essential hypertension. We present the case of...
Neurovascular compression of the rostral ventrolateral medulla (RVLM) has been described as a possible cause of refractory essential hypertension. We present the case of a patient affected by episodes of severe paroxysmal hypertension, some episodes associated with vago-glossopharyngeal neuralgia. Classical secondary forms of hypertension were excluded. Imaging revealed a neurovascular conflict between the posterior inferior cerebellar artery (PICA) and the ventrolateral medulla at the level of the root entry zone of the ninth and tenth cranial nerves (CN IX-X REZ). A MVD of a conflict between the PICA and the RVLM and adjacent CN IX-X REZ was performed, resulting in reduction of the frequency and severity of the episodes. Brain MRI should be performed in cases of paroxysmal hypertension. MVD can be considered in selected patients.
Topics: Humans; Medulla Oblongata; Hypertension; Vagus Nerve; Glossopharyngeal Nerve Diseases; Pressure
PubMed: 38488893
DOI: 10.1007/s00701-024-06032-y -
International Journal of Surgery Case... Apr 2024Trichotillomania and tricophagia, characterized by compulsive hair-pulling and subsequent ingestion which results in a compact mass of hair called trichobezoar. It...
INTRODUCTION AND IMPORTANCE
Trichotillomania and tricophagia, characterized by compulsive hair-pulling and subsequent ingestion which results in a compact mass of hair called trichobezoar. It represents an uncommon psychiatric disorder, especially in young children.
CASE PRESENTATION
This case report describes a distinctive and rare occurrence of trichotillomania, tricophagia and trichobezoar in a 11-year-old male child. Concerns raised by the parents regarding noticeable hair loss, who initially presented to medical outdoor patient with complaints of abdominal pain on and off from the last one year. He had a history of pica and weight-loss. He was then diagnosed with a gastric trichobezoar for which he was operated upon and a giant trichobezoar was retrieved from his stomach. Post-operatively patient remained admitted in ward and was discharged home on fifth post-operative day and sent for psychiatry evaluation.
CLINICAL DISCUSSION
Trichotillomania and tricophagia often have roots in psychosocial stressors, anxiety, and depression. Children may engage in hair-pulling as a coping mechanism, especially in response to familial or environmental stressors. The literature emphasizes the importance of understanding the psychosocial context to tailor interventions effectively.
CONCLUSION
Trichotillomania and tricophagia is very rare in paediatric population and if presents a multidisciplinary team comprising of a paediatrition, paediatric surgeon and paediatric psychiatrist should be involved and if diagnosed with a gastric trichobezoar should be removed surgically in order to prevent complications.
PubMed: 38471220
DOI: 10.1016/j.ijscr.2024.109520 -
Surgical Neurology International 2024Endoscopic skull base surgery requires a thorough understanding of skull base anatomy. Orientation to regional anatomy to avoid complications like internal carotid...
A computed tomography (CT)-based morphometric study of various skull base parameters and their anatomical relationships relevant to endoscopic endonasal skull base surgery.
BACKGROUND
Endoscopic skull base surgery requires a thorough understanding of skull base anatomy. Orientation to regional anatomy to avoid complications like internal carotid artery injury can be assisted by knowledge of certain bony landmarks. These landmarks are themselves highly variable structures. This study focuses on the radiological morphometric characterization of these landmarks, which can be of great assistance to surgeons for better planning of endoscopic skull base approaches.
METHODS
Computed tomography scans of patients without skull base pathologies were analyzed retrospectively for the following parameters - Vidian canal (VC) length, VC and foramen rotundum (FR) distance from midline, the angle between the axis of VC and petrous internal carotid artery (pICA) and between VC and palatovaginal canal, the horizontal, vertical and direct distances between VC and FR and the patterns of sphenoid sinus (SS) pneumatization.
RESULTS
The VC-pICA angle was more obtuse and VC and FR were placed farther off the midline on the left as compared to the right side. Similarly, the distances between VC and FR were more on the left side. The VC length and distance of VC and FR from the midline were longer in males than in females. The VC-pICA angle was more obtuse in females. The post-sellar variant was the predominant pneumatization pattern seen (57.9%), and the incidence of lateral recess pneumatization was 15%.
CONCLUSION
The results of our study can be utilized for a better understanding of the anatomy of the skull base. In skull base pathologies with distorted anatomical landmarks, a basic understanding of their interrelations can be used to have a better anatomical orientation. All these measures can help in avoiding complications and make extended endoscopic approaches safe.
PubMed: 38468683
DOI: 10.25259/SNI_1010_2023 -
Radiology. Imaging Cancer Mar 2024Purpose To investigate the prevalence of , and mutations in an oncologic cohort and determine the prevalence, clinical features, and imaging features of renal cell...
Purpose To investigate the prevalence of , and mutations in an oncologic cohort and determine the prevalence, clinical features, and imaging features of renal cell carcinoma (RCC) associated with these mutations. Secondarily, to determine the prevalence of encountered benign renal lesions. Materials and Methods From 25 220 patients with cancer who prospectively underwent germline analysis with a panel of more than 70 cancer-predisposing genes from 2015 to 2021, patients with , or mutations were retrospectively identified. Clinical records were reviewed for patient age, sex, race/ethnicity, and renal cancer diagnosis. If RCC was present, baseline CT and MRI examinations were independently assessed by two radiologists. Summary statistics were used to summarize continuous and categorical variables by mutation. Results A total of 79 of 25 220 (0.31%) patients had a germline mutation: , 17 of 25 220 (0.07%); , 22 of 25 220 (0.09%); , 39 of 25 220 (0.15%); and , one of 25 220 (0.004%). Of these 79 patients, 18 (23%) were diagnosed with RCC (, four of 17 [24%]; , four of 22 [18%]; , nine of 39 [23%]; , one of one [100%]). Most hereditary RCCs demonstrated ill-defined margins, central nonenhancing area (cystic or necrotic), heterogeneous enhancement, and various other CT and MR radiologic features, overlapping with the radiologic appearance of nonhereditary RCCs. The prevalence of other benign solid renal lesions (other than complex cysts) in patients was up to 11%. Conclusion , and mutations were present in less than 1% of this oncologic cohort. Within the study sample size limits, imaging findings for hereditary RCC overlapped with those of nonhereditary RCC, and the prevalence of other associated benign solid renal lesions (other than complex cysts) was up to 11%. Familial Renal Cell Carcinoma, Birt-Hogg-Dubé Syndrome, Carcinoma, Renal Cell, Paragangliomas, Urinary, Kidney © RSNA, 2024.
Topics: Humans; Carcinoma, Renal Cell; Germ-Line Mutation; Prevalence; Retrospective Studies; Tumor Suppressor Proteins; Kidney Neoplasms; Cysts; Proto-Oncogene Proteins; Ubiquitin Thiolesterase
PubMed: 38456787
DOI: 10.1148/rycan.230063