Short- and long-term outcomes of subtotal ear canal ablation and lateral bulla osteotomy in French bulldogs.

The objective of this retrospective study was to report the overall peri-operative complications and short- to long-term outcomes of subtotal ear canal ablation and lateral bulla osteotomy in French bulldogs with otitis media. Medical records from 2018 to 2021 were reviewed for preoperative neurological signs, surgical technique, postoperative complications, and long-term outcomes. Postoperative complications, such as a head tilt, nystagmus, ataxia, facial nerve dysfunction, as well as skin or wound infection, were recorded. Eighteen client-owned dogs (20 ears) were included in the study. Postoperative complications were observed in 5/18 dogs (6/20 ears) with 2 of them being considered major complications. Referring veterinarians and owner telephone follow-up (mean: 33 mo, range: 17 to 56 mo) were obtained for all patients. Total recovery was reported in 9/18 dogs (11/20 ears) with a postoperative improvement of the vestibular signs and facial nerve paresis within 8 wk. All dogs maintained the pinnas' natural, erect morphology, and movement.

L'objectif de cette étude rétrospective était de rapporter les complications peropératoires globales et les résultats à court et à long terme de l'ablation subtotale du conduit auditif et de l'ostéotomie de la bulle latérale chez les bouledogues français atteints d'otite moyenne. Les dossiers médicaux de 2018 à 2021 ont été examinés pour les signes neurologiques préopératoires, la technique chirurgicale, les complications postopératoires et les résultats à long terme. Les complications postopératoires, telles qu'une inclinaison de la tête, un nystagmus, une ataxie, un dysfonctionnement du nerf facial, ainsi qu'une infection de la peau ou des plaies, ont été enregistrées. Dix-huit chiens de propriétaires (20 oreilles) ont été inclus dans l'étude. Des complications postopératoires ont été observées chez 5/18 chiens (6/20 oreilles) dont 2 ont été considérées comme des complications majeures. Les vétérinaires référents et le suivi téléphonique des propriétaires (moyenne : 33 mois, intervalle : 17 à 56 mois) ont été obtenus pour tous les patients. Une récupération totale a été rapportée chez 9/18 chiens (11/20 oreilles) avec une amélioration postopératoire des signes vestibulaires et une parésie du nerf facial en 8 semaines. Tous les chiens ont conservé la morphologie et le mouvement naturels et dressés des pinnas.(Traduit par Docteur Serge Messier).

Short- to mid-term outcome and complications of closing tibial wedge osteotomy using anatomically contoured locking compression plates in small to medium breed dogs.

The objective of this retrospective case series was to report overall peri-operative complications, short- to mid-term outcome, and owner satisfaction of closing tibial wedge osteotomy (CTWO) using locking compression plates, in dogs weighing ≤ 20 kg, for the treatment of cranial cruciate ligament disease. Medical records from 2015 to 2020 were reviewed for surgical technique, intraoperative findings, and complications. Pre- and postoperative radiographs were evaluated for healing, complications, and tibial plateau angles (TPAs). A follow-up telephone questionnaire was used to evaluate patient outcome and owner satisfaction. Eighty-one client-owned dogs (12.0 kg ± 3.0 kg; 95% CI: 8.4 to 15.5) (N = 89 stifles) were included in the study. Mean tibial plateau angles at preoperative, postoperative, and 8-week follow-up were 29.7° ± 4.1° (95% CI: 25.5 to 33.8), 6.7° ± 2.6° (95% CI: 4.2 to 9.2), and 7.8° ± 2.4° (95% CI: 4.9 to 10.6), respectively. Tibial plateau angles had significantly increased at the 8-week follow-up assessment by 1.04° ± 1.8°; 95% CI: -0.8 to -2.8) compared to immediately postoperative. The postoperative complication rate was 4.49% (4 cases). Overall satisfaction was excellent with good return to limb function. Closing tibial wedge osteotomy can be performed in dogs ≤ 20 kg, using locking compression plates, achieving excellent overall owner satisfaction and return to function.

L'objectif de cette série de cas rétrospectifs était de rapporter les complications peropératoires globales, les résultats à court et à moyen terme et la satisfaction du propriétaire de l'ostéotomie de fermeture du coin tibial (CTWO) à l'aide de plaques de compression verrouillables, chez les chiens pesant ≤ 20 kg, pour le traitement de pathologie du ligament croisé crânien.Les dossiers médicaux de 2015 à 2020 ont été examinés pour la technique chirurgicale, les résultats peropératoires et les complications. Les radiographies pré- et postopératoires ont été évaluées pour la guérison, les complications et les angles du plateau tibial (TPA). Un questionnaire téléphonique de suivi a été utilisé pour évaluer les résultats des patients et la satisfaction des propriétaires.Quatre-vingt-un chiens de clients (12,0 kg ± 3,0 kg; IC à 95 % : 8,4 à 15,5) (N = 89 grassets) ont été inclus dans l'étude. Les angles moyens du plateau tibial en préopératoire, postopératoire et à 8 semaines de suivi étaient de 29,7° ± 4,1° (IC à 95 % : 25,5 à 33,8), 6,7° ± 2,6° (IC à 95 % : 4,2 à 9,2) et 7,8° ± 2,4° (IC à 95 % : 4,9 à 10,6), respectivement. Les angles du plateau tibial avaient significativement augmenté lors de l'évaluation de suivi à 8 semaines de 1,04° ± 1,8°; IC à 95 % : −0,8 à −2,8) par rapport à immédiatement postopératoire. Le taux de complications postopératoires était de 4,49 % (quatre cas). La satisfaction globale était excellente avec un bon retour à la fonction des membres.L'ostéotomie de fermeture du coin tibial peut être réalisée chez les chiens ≤ 20 kg, à l'aide de plaques de compression verrouillables, ce qui permet d'obtenir une excellente satisfaction globale du propriétaire et un retour à la fonction.(Traduit par Docteur Serge Messier).

Quality attributes of partially hydrolyzed collagen in a liquid formulation used for skin care.

BACKGROUND: The deterioration of the skin accentuates over time, affecting its aesthetic appearance. This is characterized by the weakening of the mechanisms involved in the regeneration and repair of the dermal matrix. Consequently, the skin losses elasticity and smoothness resulting in the formation of wrinkles. The alternatives for facial rejuvenation include surgery, injection of botulinum toxin, and the application of masks. Topic products are less invasive, can be self-applied, and have an increased benefit/risk relationship. AIM: We developed a liquid formulation containing collagen hydrolyzed and evaluated the product by cutting-edge technology in order to define proper its quality attributes. METHODS: We employed nuclear magnetic resonance (NMR), size-exclusion chromatography (SEC), and mass spectrometry (MS). Additionally, we analyzed its cosmetical effect in five volunteers and we demonstrate the product safety. RESULTS: Our results demonstrate the following: (a) a stable secondary structure identity associated to the known triple helix arrangement in liquid and solid states; (b) a typical conformational flexibility depending on its hydration state; (c) thermal stability confirmed by liquid- and solid-state nuclear magnetic resonance schemes; and (d) a molecular mass distribution of peptides between 0.5 and 19.5 kDa. The product faded wrinkles in the forehead, an effect that remained after removing the mask. The formula was non-irritating and hypoallergenic. CONCLUSION: We characterized, using state-of-the-art methodologies, the quality attributes that are critical for the safety and beneficial effect of a new collagen-containing formula.

Value of preoperative HE4 as predictor of advanced disease in endometrioid endometrial cancer.

OBJECTIVE: To explore the predictive value of serum human epididymis protein 4 (HE4) marker in the preoperative prediction of the risk of advanced disease in the endometrioid subtype of endometrial cancer, and its association with poor prognostic factors. In addition, a cut-off value of HE4 was defined to classify patients according to these results. METHODS: Prospective and multicenter cohort analytical pilot study of patients operated for endometrial cancer at the Miguel Servet University Hospital of Zaragoza (Spain) and the Complejo Universitario of León (Spain) from January 2017 to May 2019. Preoperative serum levels of HE4 were analyzed by clinical and pathologic characteristics. RESULTS: In all, 126 patients were included. A statistically significant association was found between the preoperative HE4 value and node involvement (P = 0.008), late-stage disease (P = 0.003), high histologic grade (P = 0.007), deep myometrial invasion (P = 0.001), lymphovascular space invasion (P = 0.001), and other pathologic factors. In addition, an HE4 cut-off value (156.4 pmol/L) has been determined to predict, preoperatively, which patients will present with early stage disease. CONCLUSIONS: The preoperative marker HE4 is a useful tool in the preoperative study of patients with endometrial cancer as it relates to late-stage disease as well as other prognostic factors in the endometrioid subtype of endometrial cancer.

Validation of a cell-based colorimetric reporter gene assay for the evaluation of Type I Interferons.

The biotherapeutic type I interferons (IFN-I) are indicated to treat several diseases. These products are regulated to guarantee safety and efficacy through critical quality attributes. For this purpose, the development of robust assays is required, followed by its validation to demonstrate their suitability for its intended purpose. Despite there are some commercial kits to evaluate IFN-I signaling, these are focused on measuring in vitro biological response instead of their validation, which is a pharmaceutical industry requirement. The aim of this work was to validate the HEK-Blue IFN-α/ß system evaluating the biological activity of IFN-α/ß under good laboratory practices, according to international standards. Our results demonstrated that HEK-Blue IFN-α/ß system comply with accuracy (r2>0.95) precision (CV < 20%) and specificity for both IFN-α/ß; confirming that this assay is robust for this biotherapeutics' evaluation. Thereby, this bioassay could be implemented as a complementary method to the classical anti-proliferative and anti-viral assays under quality control environments.

Short- and long-term outcome after transcondylar screw placement to treat humeral intracondylar fissure in dogs.

OBJECTIVE: To describe the postoperative complications and long-term functional outcome after surgical management of humeral intracondylar fissure (HIF) by transcondylar screw (TCS) placement. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Nineteen dogs (26 elbows) METHODS: Medical records (2000-2009) were reviewed for dogs with a diagnosis of HIF according to results of computed tomography and treated by TCS placement at a single referral institution. Collected data included signalment, surgical technique, surgical duration, surgeon experience, use of antibiotics, and the presence and nature of any complications. Owner questionnaire, orthopedic examination, and pressure platform analysis were used to assess long-term outcome. The relationship between these variables was statistically analyzed. RESULTS: In total, 18 of 26 surgically managed elbows were diagnosed with a postoperative complication; 11 of these consisted of a surgical site infection (SSI). No risk factors for short-term complications or long-term outcome were identified. Dogs with an SSI (n = 11) were 28 times more likely to have an unsatisfactory long-term outcome than dogs without an SSI (n = 8). Symmetry indices (SI) between thoracic and pelvic limbs did not return to published normal values. There was no difference in the SI of dogs with HIF and a surgically repaired contralateral humeral condylar fracture. CONCLUSION: Placement of a TCS was commonly associated with short-term complications, affecting long-term outcome. CLINICAL SIGNIFICANCE: The high complication rate after placement of lateromedial TCS provides evidence to justify the development of alternative strategies to manage HIF.

A comparison of fixation methods for supracondylar and distal humeral shaft fractures of the dog and cat.

Retrospective analysis of case records from dogs and cats diagnosed with supracondylar or distal diaphyseal humeral fractures was performed. Complications were compared and outcome was assessed at final follow-up and by owner questionnaire. A total of 37 cases (25 dogs and 12 cats) were included. Methods used consisted of plates and screws or external skeletal fixator (ESF). The ESF was associated with a significantly higher rate of minor complications (14/22) compared with plates and screws (2/15). There was no difference in major or catastrophic complications between fixation methods. Major complications occurred in 4/37 cases and catastrophic complications occurred in 3/37 cases. Good or excellent outcome was achieved in 24/33 of cases. There was no difference in outcome between dogs and cats. Plates and screws or ESF can be successful methods of managing supracondylar and distal diaphyseal humeral fractures in dogs and cats. Prognosis may be more guarded, however, than previously reported.

Comparaison des méthodes de fixation pour les fractures sus-condyliennes et distales de la diaphyse chez le chien et le chat. Une analyse rétrospective des dossiers de cas de chiens et de chats diagnostiqués avec des fractures sus-condyliennes et distales de l'humérus a été réalisée. Les complications ont été comparées et les résultats ont été évalués au suivi final et à l'aide d'un questionnaire rempli par le propriétaire. Trente-sept cas (25 chiens et 12 chats) ont été inclus au total. Les méthodes utilisées comportaient des plaques et des vis ou un fixateur squelettique externe (FSE). Le FSE était associé à un taux significativement supérieur de complications mineures (14/22) comparativement aux plaques et aux vis (2/15). Il n'y avait aucune différence pour les complications majeures ou catastrophiques entre les méthodes de fixation. Des complications majeures se sont produites dans 4/37 cas et des complications majeures se sont produites dans 3/37 cas. Un résultat adéquat ou excellent a été obtenu dans 24/33 des cas. Il n'y avait aucune différence au niveau des résultats entre les chiens et les chats. Les plaques et les vis ou le FSE peuvent être des méthodes réussies de gestion des fractures sus-condyliennes et distales de la diaphyse chez les chiens et les chats. Cependant, le pronostic peut être plus réservé que ce qui avait été précédemment signalé.(Traduit par Isabelle Vallières).

Cáncer de endometrio y trompa sincrónicos. Un reto diagnóstico / Synchronous endometrial and tubal cancer. A diagnostic challenge

Los tumores sincrónicos de endometrio y ovario son una entidad conocida y bien documentada, pero las series publicadas que recogen casos de cáncer de endometrio y trompa son mucho más limitadas. Dadas las implicaciones terapéuticas y pronósticas que se derivan de su distinción con la enfermedad metastásica es importante realizar una correcta valoración del cuadro. Presentamos dos pacientes con cáncer en endometrio y trompa simultáneos y cómo se llegó al diagnóstico de que uno de ellos se trataba de tumores sincrónicos y de metástasis el otro (AU)

Synchronous tumors of the endometrium and ovary are a well-known and well described entity. There are only a few cases in the literature of simultaneous endometrial cancer and fallopian tubes cancer. It is important to differentiate it from metastatic disease because their therapeutic and prognostic implications. We report two patients with concurrent endometrial and tube cancer and how the diagnosis was made: synchronic tumors in the first patient and metastases in the other (AU)

Diagnóstico prenatal y repercusiones perinatales de la persistencia de vena cava superior izquierda. Serie de casos y revisión bibliográfica / Prenatal diagnosis and perinatal results of the persistent left superior vena cava. Cases series and literature review

Resumen Objetivo Describir las anomalías asociadas y las repercusiones perinatales de la persistencia de la vena cava superior izquierda en el feto y revisar la bibliografía. Materiales y métodos Estudio descriptivo, transversal y retrospectivo efectuado de enero de 2009 a diciembre 2012 en la Unidad de Diagnóstico Prenatal del Departamento de Obstetricia y Ginecología del Hospital Universitario Miguel Servet de Zaragoza, España. El estudio incluyó a todos los fetos con diagnóstico prenatal de persistencia de la vena cava superior izquierda establecido durante los controles gestacionales ecográficos. Resultados Se diagnosticaron 21 casos de persistencia de la vena cava superior izquierda entre las 20 y 35 semanas de embarazo. El 29% de los casos se detectó en la ecografía de las 20 semanas; 9 casos (43%) tuvieron anomalías cardiacas o extracardiacas asociadas y en 2 casos (10%) se encontró, además, trisomía 21, ambos con anomalías cardiacas asociadas. En 4 casos (19%) no hubo vena cava superior derecha. En los casos aislados la evolución fue favorable. Conclusiones Puesto que la persistencia de la vena cava superior izquierda se asocia, frecuentemente, con anomalías cardiacas y extracardiacas está justificada la ecografía morfológica fetal detallada y una ecocardiografía con posterior seguimiento antenatal. Si es aislada, la evolución obstétrica y el pronóstico perinatal serán favorables, como ha sucedido en los casos de persistencia de la vena cava superior izquierda aislados, con ausencia de vena cava superior derecha.

Abstract Objective To describe the associated anomalies and perinatal results in fetuses diagnosed with persistence of the left superior vena cava and to conduct a review of the literature. Materials and methods A descriptive, cross-sectional, retrospective study conducted between January 2009 and December 2012 in the Prenatal Diagnostic Unit of the Obstetrics and Gynecology Department at the Miguel Servet University Hospital in Zaragoza, Spain. The study included all fetuses with prenatal diagnosis of persistence of the left superior vena cava performed during gestational ultrasound controls in that period. Results 21 cases of persistence of the left superior vena cava were diagnosed between 20 and 35 weeks. Only 29% of the cases were detected on ultrasound at 20 weeks. 9 cases (43%) had associated cardiac or extracardiac anomalies and two cases (10%) associated trisomy 21, both with associated cardiac anomalies. In 4 cases (19%) there was an absence of right superior vena cava. In isolated cases, the evolution was favorable. Conclusions The presence of persistence of the left superior vena cava is frequently associated with cardiac and extracardiac abnormalities, so in the case of diagnosis, detailed fetal morphological ultrasound and echocardiogram are justified with subsequent antenatal follow-up. In the case of being isolated, it has an obstetric evolution and a favorable perinatal prognosis, results that were also presented in isolated persistence of the left superior vena cava cases with absence of right superior vena cava.

Acetato de ulipristal en el diagnóstico diferencial de carcinoma de endometrio / Ulipristal acetate in the differential diagnosis of endometrial carcinoma

Los miomas uterinos son las tumoraciones genitales más frecuentes cuyo tratamiento más habitual es el quirúrgico. Actualmente existe un tratamiento médico eficaz para reducir su volumen y la clínica asociada que es el acetato de ulipristal (AU), que es un modulador selectivo de los receptores de la progesterona. A nivel endometrial puede ocasionar cambios histológicos que cuando son muy marcados plantean dudas diagnósticas. Se presenta el caso de una paciente con útero miomatoso sintomático bajo tratamiento con AU, la histología en las muestras de biopsia planteó el diagnóstico diferencial con adenocarcinoma de endometrio.

Uterine fibroids are the most common genital tumors and the most common treatment is surgery. Actually there is an effective medical treatment to reduce its volume and the symptoms. It is ulipristal acetate (UA), a selective progesterone receptor modulator. In the endometrium it can cause some peculiar histological changes. We present a patient with symptomatic uterine fibroid with UA, and it was difficult to make differential diagnosis with endometrial cancer.

Are congenital malformations more frequent in fetuses with intrahepatic persistent right umbilical vein? A comparative study.

OBJECTIVE: Persistent right umbilical vein (PRUV) is a vascular anomaly where the right umbilical vein remains as the only conduit that returns oxygenated blood to the fetus. It has classically been described as associated with numerous defects. We distinguish the intrahepatic variant (better prognosis) and the extrahepatic variant (associated with worse prognosis). The objective of this study was to compare rates of congenital malformations in fetuses with intrahepatic PRUV (I-PRUV) versus singleton pregnancies without risk factors. MATERIALS AND METHODS: A multicenter, crossover design, comparative study was performed between 2003 and 2013 on fetuses diagnosed with I-PRUV (n=56), and singleton pregnancies without congenital malformation risk factors (n=4050). RESULTS: Fifty-six cases of I-PRUV were diagnosed (incidence 1:770). A statistically significant association between I-PRUV and the presence of congenital malformations (odds ratio 4.321; 95% confidence interval 2.15-8.69) was found. This positive association was only observed with genitourinary malformations (odds ratio 3.038; 95% confidence interval 1.08-8.56). CONCLUSION: Our rate of malformations associated with I-PRUV (17.9%) is similar to previously published rates. I-PRUV has shown a significant increase in the rate of associated malformations, although this association has only been found to be statistically significant in the genitourinary system. Noteworthy is the fact that this comparative study has not pointed to a significant increase in the congenital heart malformation rate. Diagnosis of isolated I-PRUV does not carry a worse prognosis.

Incidence of complications associated with tibial tuberosity advancement in Boxer dogs.

OBJECTIVE: To retrospectively review and describe the incidence of complications associated with tibial tuberosity advancement (TTA) surgical procedures in a group of Boxer dogs (n = 36 stifles) and compare the data with a non-Boxer control population (n = 271 stifles). METHODS: Retrospective analysis of medical records to identify all dogs that underwent TTA surgery due to cranial cruciate ligament disease. These records were categorized into two groups: Boxer dogs and non-Boxer dogs (controls - all other breeds). RESULTS: Of the 307 stifles included, 69 complications were reported in 58 joints. The complication rate differed significantly for Boxer dogs (16/36 stifles) and non-Boxer dogs (42/271 stifles), corresponding to an odds ratio of 5.8 (confidence interval: 1.96-17.02; p-value <0.001). Boxer dogs were more likely to undergo revision surgery and to develop multiple complications. The incidence of tibial tuberosity fractures requiring surgical repair (2/36 versus 1/271) and incisional infections requiring antibiotic treatment (three in each group) was significantly higher in the Boxer group. CLINICAL SIGNIFICANCE: Boxer dogs had more major and multiple complications after TTA surgery than the control non-Boxer group; these complications included higher rates of revision surgery, tibial tuberosity fractures requiring stabilization, and infection related complications. The pertinence and value of breed-specific recommendations for cranial cruciate ligament disease appears to be a subject worthy of further investigation.

[Introduction of virtual patients to clinical case portfolios for undergraduate medical students]. / Incorporación de paciente virtual en portafolio de estudiantes de medicina de pregrado.

BACKGROUND: In 2007, a Clinical-Case-Portfolio (CCP) was introduced as a new assessment instrument for fourth grade undergraduate medical students. Since then, several changes have been implemented such as reduction on the number of clinical cases, peer review and the introduction of virtual patient to the portfolio. AIM: To describe the virtual patient model incorporated to the CCP and assess the perception of this change and its effects on the performance of undergraduate students. MATERIAL AND METHODS: Virtual patients were implemented based on prototype clinical cases with specific syndromes. Students’ perceptions about CCP before and after the introduction of virtual patients were evaluated using a validated questionnaire that was answered voluntarily and anonymously. RESULTS: Overall perception of CCP significantly improved after the incorporation of virtual patients (97.1 ± 24.9 and 111.3 ± 25.7 points; 57.8 and 66.2% respectively). The same improvements were observed for the domains “Student Learning”, “Organization and Evaluation”, “Teaching Methodology” and “Integration”. In both years, students obtained high grades in CCP evaluations. However CCP grades were not significantly correlated with integrated final grades. CONCLUSIONS: The incorporation of virtual patients improved undergraduate students’ perception of CCP.

Schwannoma benigno retroperitoneal gigante: diagnóstico incidental en paciente con masa pélvica sospechosa de cáncer de ovario / Benign giant retroperitoneal schwannoma: incidental diagnosis in a patient with pelvic mass mimicking ovarian cancer

Las tumoraciones del compartimento sacro son poco frecuentes (1:40.000 ingresos hospitalarios), siendo los tumores benignos más infrecuentes. Los schwannomas son tumores benignos compuestos por células de Schwann con crecimiento lento, permaneciendo las pacientes asintomáticas durante gran parte de su historia natural. Se expone el caso de una paciente de 82 años, sin antecedentes de interés, que presenta masa pélvica y marcadores tumorales negativos, con diagnóstico de sospecha radiológico de cáncer de ovario, filiada como schwannoma benigno retroperitoneal gigante tras estudio anatomopatológico definitivo. Tras tratamiento quirúrgico óptimo, la paciente se encuentra libre de enfermedad tras 5 años de seguimiento (AU)

Sacral tumors are rare (1:40,000 hospital admissions) and benign sacral tumors are even more uncommon. Schwannomas are slow-growing benign tumors composed of Schwann cells and remain asymptomatic for much of their natural history. We report the case of an 82-year-old woman with no relevant medical history and a pelvic mass and negative tumor markers. The presumptive radiological diagnosis was ovarian cancer but the definitive pathological diagnosis was benign giant retroperitoneal schwannoma. After successful surgical treatment, the patient is disease-free after 5 years of follow-up (AU)

Incorporación de paciente virtual en portafolio de estudiantes de medicina de pregrado / Introduction of virtual patients to clinical case portfolios for undergraduate medical students

Background: In 2007, a Clinical-Case-Portfolio (CCP) was introduced as a new assessment instrument for fourth grade undergraduate medical students. Since then, several changes have been implemented such as reduction on the number of clinical cases, peer review and the introduction of virtual patient to the portfolio. Aim: To describe the virtual patient model incorporated to the CCP and assess the perception of this change and its effects on the performance of undergraduate students. Material and Methods: Virtual patients were implemented based on prototype clinical cases with specific syndromes. Students’ perceptions about CCP before and after the introduction of virtual patients were evaluated using a validated questionnaire that was answered voluntarily and anonymously. Results: Overall perception of CCP significantly improved after the incorporation of virtual patients (97.1 ± 24.9 and 111.3 ± 25.7 points; 57.8 and 66.2% respectively). The same improvements were observed for the domains “Student Learning”, “Organization and Evaluation”, “Teaching Methodology” and “Integration”. In both years, students obtained high grades in CCP evaluations. However CCP grades were not significantly correlated with integrated final grades. Conclusions: The incorporation of virtual patients improved undergraduate students’ perception of CCP.

Mechanical comparison of loop and crimp configurations for extracapsular stabilization of the cranial cruciate ligament-deficient stifle.

OBJECTIVE: To biomechanically compare different loop and crimp configurations used for extracapsular suture stabilization of the CCL-deficient stifle. STUDY DESIGN: In vitro study. SAMPLE POPULATION: Crimped loop constructs of 100 lb Ande type nylon leader line in 7 different configurations comprising single and double loops, single and double crimps, and the interlocking loop configuration. METHODS: Constructs premade on external skeletal fixator bars 60 mm apart and tested in tension with a custom-made split circular arm mounted on a table-top materials testing machine. Data were derived from force/displacement plots. In "load to failure" test (10/group) constructs were loaded to failure with distraction rates of 10 mm/min; ultimate load, tension at 2 mm elongation and failure were recorded. In "staircase" test (5/group) constructs cycled at 100 N/s from 75 N with incremental increases of 50 N/cycle; ultimate load, maximum tension before elongation at rest over 2 mm and failure were recorded. In "cycling and jumping" test (10/group) 3 of 7 constructs cycled at 100 N/s 100 times from 50 to 100 N, then 5 times from 50 to 600 N; failure and elongation at cycles 1, 50 and 100 and at jumps 1 to 5 recorded. RESULTS: Double-loop double-crimp configurations were statistically superior to all other configurations in ultimate load, and to single-loop and interlocking loop configurations in elongation in "load to failure" and "staircase" tests. In "cycling and jumping" test the interlocking loop configuration specimens elongated significantly more than the others and only in the double-loop double-crimp group did all constructs complete the test. CONCLUSIONS: Double-loop double-crimp configurations are mechanically superior to other previously described configurations.

Femoral head and neck excision in cats: medium- to long-term functional outcome in 18 cats.

OBJECTIVE: To assess the medium- to long-term functional outcome of cats after femoral head and neck excision (FHNE) using an owner-completed questionnaire. METHODS: Cats that had FHNE and were free of other orthopaedic or medical conditions that could affect their mobility, other than the studied coxofemoral joint(s), were included. A specific owner-completed questionnaire was used at a minimum of 4 months postoperatively. The questionnaire assessed the ability of the cats to perform normal feline activities, change of demeanour or behaviour, the necessity for long-term analgesia and the time taken to resume normal activities. RESULTS: Eighteen cats had undergone uni- or bilateral FHNE and met the inclusion criteria. All but one cat could perform normal feline activities without or with slight difficulty at follow-up. The aforementioned cat had notable, persistent difficulty in climbing. The majority of the cats took between 1 and 2 months to resume normal activity. No change in demeanour or behaviour was noted in any of the cats and none of the cats required long-term analgesia. CONCLUSIONS AND RELEVANCE: Based on the owner-completed questionnaire, cats have good-to-excellent medium- to long-term functional outcome after adequately performed FHNE.

Epineurial repair of an iatrogenic facial nerve neurotmesis after total ear canal ablation and lateral bulla osteotomy in a dog with concurrent cranio-mandibular osteopathy.

A 7-year-old male entire West Highland white terrier was referred to the Small Animal Hospital at the University of Glasgow for bilateral, chronic, medically unresponsive otitis media and externa. A history of cranio-mandibular osteopathy was also reported. Bilateral total ear canal ablation and lateral bulla osteotomy was performed with the aid of a pneumatic burr. Extensive bone proliferation was present bilaterally originating from the caudal mandibular ramus and tympanic bulla which incorporated the horizontal canal on each side. The right facial nerve was identified leaving the stylomastoid foramen and running in a cranial direction through a 1.5 cm diameter cuff of bone surrounding the horizontal canal and external acoustic meatus. Despite careful dissection, a facial nerve neurotmesis ensued which required microsurgical epineurial repair. Neurologic examination performed 12 h post-operatively revealed abnormalities consistent with right facial nerve paralysis. At 3 months, the facial nerve function was found to have improved significantly and was assessed to be normal four months after surgery. To the authors' knowledge, this clinical communication described the first reported clinical case where unilateral facial nerve paralysis resulting from iatrogenic facial nerve neurotmesis was successfully treated by microsurgical epineurial repair.

Trans-iliac pin/bolt/screw internal fixation for sacroiliac luxation or separation in cats: six cases.

Trans-iliac pin, bolt or screw stabilisation was performed on six cats with sacroiliac (SI) luxation and separation. For the purpose of this study, SI luxation is defined as the separation of the iliac wing from the sacrum without fracture of the sacral or iliac wing; SI separation is defined as the separation of the iliac wing from the sacrum secondary to fracture of the sacrum and/or the iliac wing. Complications, surgical time and medium-to-long-term outcome were assessed by a retrospective review of the clinical records and owner questionnaires. Postoperative reduction of the SI joint was good-to-excellent in all cases and the outcome was considered good-excellent in all cats apart from one, where the trans-iliac bolt migrated dorsally from the iliac wing. This cat had bilateral SI luxations. Based on our results, trans-iliac fixation of SI luxation/separation is associated with good clinical outcome and should be considered as a treatment option in unilateral SI luxation in cats. Caution should be exercised in the use of trans-iliac pin/bolt as the sole method of stabilisation in bilateral SI luxations.