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Poultry Science May 2024For many species, scales are used to classify discomfort and stress (e.g., facial expression/pain scales). Although a significant number of vertebrates used for...
For many species, scales are used to classify discomfort and stress (e.g., facial expression/pain scales). Although a significant number of vertebrates used for scientific purposes are chickens, a corresponding scale for birds has not yet been established. We developed a Stressed Chicken Scale (SCS) to investigate whether it is possible to assess discomfort in a chicken by its body posture. A selective review with additional handsearch was conducted to find suitable parameters for visual stress assessment. Seven potential body signals were identified: Tail and head position, eye closure, beak opening, leg and wing position, and plumage fullness (ruffled or fluffed up feathers). The SCS was evaluated for interobserver reliability with veterinary students (n = 20), using randomized pictures of stressed and unstressed chickens in lateral view (n = 80). Observers were able to identify the body signals on the pictures after a brief training session. Agreement scores for interobserver agreement ranged from κ = 0.31 (fair agreement) for eye closure to κ = 0.78 (substantial agreement) for beak opening. We found that the number of body signals displayed in a stressed expression had an impact on observers' overall assessment of the chickens, for example, chickens were more likely to be rated as stressed if more than 4 signals indicative of stress were present. We conclude that the 7 individual body signals can be used to identify discomfort in chickens.
PubMed: 38878744
DOI: 10.1016/j.psj.2024.103875 -
International Journal of Surgery Case... Jun 2024Purtscher retinopathy is the rare form of occlusive microvasculopathy, characterized by multiple retinal white areas around the optic nerve head and fovea with...
INTRODUCTION AND IMPORTANCE
Purtscher retinopathy is the rare form of occlusive microvasculopathy, characterized by multiple retinal white areas around the optic nerve head and fovea with paravascular clearing and may be related to intraretinal hemorrhages. Acute Pancreatitis (AP) is one of the most common gastrointestinal reasons for hospital admissions globally. The complications of Acute Pancreatitis may include Purtscher's-like retinopathy, which has a low incidence rate of less than 0.24 instances per million cases. This case report highlights the value of thorough medical history taking and examination, and it apprises the consideration of ophthalmological manifestation in patients of Acute Pancreatitis.
CASE PRESENTATION
A 34-year-old female came to the emergency room due to intense abdominal pain associated with nausea and vomiting, which worsened over the last 24 h. The pain was described as continuous, sharp, and cramping-like in the upper abdomen, radiating to the back. Lab tests revealed elevated serum amylase and lipase levels, indicating pancreatitis, along with slight leukocytosis. A contrast-enhanced CT scan confirmed acute pancreatitis with mild inflammation and enlargement of the pancreas. Two days after admission, the patient experienced a sudden and painless loss of central vision in both eyes. There was no history of trauma or any other significant relevant history, other than pancreatitis. The ophthalmologist's examination found reduced visual acuity (6/60 in the right eye, 3/60 in the left eye), normal corneas, and anterior chambers.
DISCUSSION
Inkeles and Walsh established the first link between acute pancreatitis and Purtscher-like retinopathy when they reported three cases of the distinctive retinal appearance in individuals with acute pancreatitis in 1975.
CONCLUSION
The recovery and prognosis in cases of Purtscher-like retinopathy is variable and further research is required to ascertain the usage of corticosteroids and pentoxifylline in improving the course of a patient's with Purtscher's-like retinopathy.
PubMed: 38875828
DOI: 10.1016/j.ijscr.2024.109881 -
Clinical Practice and Cases in... May 2024A 52-year-old female presented to the emergency department with four days of right periorbital pain, ipsilateral temporal headache, diplopia, and photophobia. Physical...
CASE PRESENTATION
A 52-year-old female presented to the emergency department with four days of right periorbital pain, ipsilateral temporal headache, diplopia, and photophobia. Physical examination of the right eye revealed painful ophthalmoplegia, cranial nerves III and VI paresis, increased intraocular pressure, and mild proptosis. Magnetic resonance venogram and magnetic resonance imaging orbits with contrast demonstrated an abnormal signal surrounding the right cavernous sinus/petrous apex. Tolosa-Hunt syndrome (THS) was diagnosed. Per neurology recommendations, the patient was placed on a steroid regimen over the course of three weeks. She was discharged on hospital day nine following resolution of symptoms. She had no recurrence of symptoms or residual deficits noted at her two-week follow-up appointment.
DISCUSSION
With an estimated annual incidence of one case per million, THS is a sinister etiology of unilateral headache, painful ophthalmoplegia, and oculomotor palsy. Tolosa-Hunt syndrome is caused by granulomatous inflammation in the cavernous sinus and is highly responsive to corticosteroids. Magnetic resonance imaging studies of the cavernous sinus and orbital apex are highly sensitive for THS and characteristically show enlargement and focal-enhancing masses within the affected cavernous sinus.
PubMed: 38869347
DOI: 10.5811/cpcem.2582 -
Spine Surgery and Related Research May 2024The major symptoms of lumbar disc herniation (LDH) are low back pain, radiative lower extremity pain, and lower limb movement disorder. Patients with LDH suffer from... (Review)
Review
The major symptoms of lumbar disc herniation (LDH) are low back pain, radiative lower extremity pain, and lower limb movement disorder. Patients with LDH suffer from great distress in their daily life accompanied by severe economic hardship and difficulty in self-care, with an increasing tendency in the aging population. PubMed and the Cochrane Central Register of Controlled Trials were searched for relevant studies of spontaneous resorption or regression in LDH after conservative treatment and for other potential studies, which included those from inception to June 30, 2023. The objective of this narrative review is to summarize previous literatures about spontaneous resorption in LDH and to discuss the mechanisms and influencing factors in order to assess the probability of spontaneous resorption by conservative treatment. Spontaneous resorption without surgical treatment is influenced by the types and sizes of the LDH, inflammatory responses, and therapeutic factors. If the lumbar disc herniated tissue comprises a higher percentage of cartilage or modic changes have been shown on magnetic resonance imaging (MRI), resorption in LDH is prevented. The bull's eye sign on enhanced MRI, which is a ring enhancement around a protruding disc, is a vital indicator for easy reabsorption. In addition, the type of extrusion and sequestration in LDH could forecast the higher feasibility of natural reabsorption. Moreover, the higher the proportion of protrusion on the intervertebral disc tissue within the spinal canal, the greater the likelihood of reabsorption. Therefore, which illustrates the feasibility of conservative treatments for LDH. Nonsurgical management of LDH with clinical symptoms is recommended by the authors.
PubMed: 38868799
DOI: 10.22603/ssrr.2023-0152 -
Cureus May 2024The diagnosis of skin lesions involving the eyes can be challenging, especially when uncommon etiologies are considered. We present a case of a 52-year-old female...
The diagnosis of skin lesions involving the eyes can be challenging, especially when uncommon etiologies are considered. We present a case of a 52-year-old female initially diagnosed with blepharoconjunctivitis but later found to have a subcutaneous heartworm infection. The patient experienced recurrent episodes of unilateral palpebral edema, pain, pruritus, and a sensation of a foreign body in her eye. Upon examination, a vermiform structure with peristaltic movements was observed, raising suspicion of subcutaneous dirofilariasis and prompting further investigations. Serological tests confirmed the presence of anti- spp. antibodies. Surgical removal of the worm led to the resolution of symptoms. This case highlights the importance of considering uncommon etiologies, such as subcutaneous heartworm infection, in patients presenting with atypical migratory skin lesions or ocular manifestations when there is no definite diagnosis and the condition does not respond to usual medical treatment.
PubMed: 38868288
DOI: 10.7759/cureus.60208 -
Frontiers in Public Health 2024This study aims to verify the effectiveness of M-O-A telenursing intervention model in improving the health status and quality of life of the empty-nest older adult... (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
This study aims to verify the effectiveness of M-O-A telenursing intervention model in improving the health status and quality of life of the empty-nest older adult individuals with chronic diseases by a randomized comparative trial.
METHODS
M-O-A telenursing intervention model was constructed based on the needs of the participants. The control group ( = 39) received routine nursing, the experimental group ( = 39) received M-O-A telenursing intervention in addition to routine nursing. After 12 weeks of intervention, the intervention effects of being a participant in the two groups were evaluated. SPSS 26.0 was used for data analysis.
RESULTS
After 12 weeks of intervention, for the experimental group, each dimension of quality of life based on EQ-5D-3L became better, especially for "pain/discomfort," "anxiety/depression," "HRQoL" and "EQ-VAS" (all < 0.05) and each dimension of quality of life based on SF-36 became better too, especially for "GH," "BP," "RE," "MH," "VT," "SF," "PCS," "MCS," "SF-36" (all < 0.05). In addition, there was a statistical downward trend in blood pressure, blood glucose, weight, BMI, fat rate, nap duration, number of nocturnal awakenings, light sleep rate and a statistical upward trend in water rate, basal metabolic rate, nighttime sleep duration, deep sleep rate, rapid eye movement sleep rate, especially at the end of intervention (all < 0.05). While for the control group, there was no statistical improvement in all these aspects.
CONCLUSION
The M-O-A telenursing model could effectively regulate quality of life and health condition of the empty-nest older adult individuals with chronic diseases, making it worthy of further promotion and application.
Topics: Humans; Quality of Life; Male; Female; Aged; Chronic Disease; Health Status; Middle Aged; Surveys and Questionnaires; Telemedicine; Aged, 80 and over
PubMed: 38868161
DOI: 10.3389/fpubh.2024.1239445 -
Aesthetic Surgery Journal. Open Forum 2024Injecting soft-tissue fillers, such as hyaluronic acid, has become an extremely popular method of facial augmentation. Although rare, adverse effects, ranging from...
Injecting soft-tissue fillers, such as hyaluronic acid, has become an extremely popular method of facial augmentation. Although rare, adverse effects, ranging from cosmetically dissatisfactory to dangerous, may occur. The most severe adverse effect of these is vascular occlusion of the central retinal artery, resulting in vision loss. Protocols for the treatment of filler-induced blindness have not been well established, but there is evidence to suggest that hyperbaric oxygen therapy (HBOT) may aid in the therapeutic algorithm for filler-induced blindness. We present a clinical case of filler-induced blindness successfully treated with prompt administration of HBOT. A 38-year-old healthy female presented to the emergency room after immediate pain and complete vision loss following an at-home injection of mail-order filler into the left glabella and medial eyebrow. After treatment with hyaluronidase and ocular massage, neither of which relieved her symptoms, she received HBOT within 10 h of the injury, after which her vision improved significantly. After 2 additional sessions, the patient had complete vision recovery. This case report contributes to the very sparse literature documenting successful treatment of filler-induced blindness using HBOT, advocating for further study, and possible incorporation into the treatment algorithm for filler-induced blindness. Improper soft-tissue filler administration possesses a potential risk of severe adverse effects. It is crucial that the medical community is aware of treatments that offer the highest chance of visual recovery and sustained benefit for patients.
PubMed: 38863892
DOI: 10.1093/asjof/ojae036 -
Clinical Ophthalmology (Auckland, N.Z.) 2024To assess ocular pain in patients undergoing multiple intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) who have previous factors that may...
PURPOSE
To assess ocular pain in patients undergoing multiple intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) who have previous factors that may influence pain sensitivity.
METHODOLOGY
This is a prospective, observational, case series study involving patients who underwent multiple (≥3) pro re nata intravitreal injections of ranibizumab or aflibercept to treat any cause of chorioretinal vascular disease. Ocular pain was assessed by the numerical analog scale during intravitreal injection. For this study, the main variable was ocular pain and the secondary variables included age, sex, previous history of glaucoma, primary retinal vascular disease, severe dry eye history, trigeminal pain, scleral buckle surgery, collagen diseases, fibromyalgia, severe migraine history, pars plana vitrectomy, scleral thickness measurements, and type of anti-VEGF.
RESULTS
In a total of 894 patients, 948 eyes (4822 intravitreal injections), 793 patients (88.6%) had ocular pain sensitivity between no pain to mild pain, 80 patients (8.9%) had moderate ocular pain, 15 patients (1.6%) had severe ocular pain, and 6 patients (0.7%) had extremely severe ocular pain. Patients with severe dry eye (p = 0.01) and previous history of scleral buckle surgery (p = 0.01) showed a significant correlation with ocular pain during intravitreal injection. Pars plana scleral thickness (>550 um) and diabetic neuropathy were associated with ocular pain but did not meet the criteria for statistical significance (p = 0.09 and p = 0.06, respectively).
CONCLUSION
Dry eye and prior scleral buckle surgery may contribute to pain associated with intravitreal injection. These issues should be taken into consideration in patients undergoing multiple intravitreal injections.
PubMed: 38863678
DOI: 10.2147/OPTH.S463016 -
Clinical Case Reports Jun 2024The most frequently reported adverse reaction to zoledronic acid is an acute phase reaction resembling influenza. While rarer adverse events such as osteonecrosis of the...
The most frequently reported adverse reaction to zoledronic acid is an acute phase reaction resembling influenza. While rarer adverse events such as osteonecrosis of the jaw and atypical femoral fractures have gained significant recognition, the ocular adverse effects, particularly scleritis, are not yet fully comprehended. Here, we present the case of a 75-year-old female patient with osteoporosis who developed bilateral redness and intense eye pain 48 h after receiving a 5 mg intravenous dose of zoledronic acid. Clinical presentation suggested bilateral conjunctivitis, but treatment with levofloxacin eye drops and acyclovir ophthalmic gel exacerbated the symptoms over 2 days, predominantly affecting the left eye. Ocular ultrasonography revealed thickening of the left eyeball wall with a "T" sign, while an orbital CT scan showed increased thickness of the left sclera. Treatment with methylprednisolone 80 mg intravenous infusion twice daily led to gradual symptom improvement and eventual resolution of inflammation. This report, based on a review of relevant literature, investigates the treatment and outcomes of zoledronic acid-induced scleritis, emphasizing the importance for clinicians to promptly identify and manage this rare and serious ocular adverse reaction.
PubMed: 38855089
DOI: 10.1002/ccr3.9068