Predicted and actual quality of life changes following renal transplantation.

An exploratory-descriptive design was used to examine quality of life (QoL) changes in this follow-up study of renal transplant recipients 16-26 months after transplantation. Of 57 patients interviewed for the original study conducted at transplantation, 39 were interviewed. Interviews included demographic information, open-ended QoL questions, and identification of positive and negative QoL changes. T-test examined differences between pretransplant QoL expectations and post-transplant QoL changes. McNemar's Test determined the categories where changes were more correctly anticipated. Results indicate that although staff more accurately anticipate the degree to which patients' QoL changes, patients more accurately anticipate the types of changes that occur.

Ultrasonographic appearance and correlative anatomy of the soft tissues of the distal extremities in the horse.

The diagnostician should be familiar with the normal ultrasound appearance (size, shape, position, and textural quality) of each structure examined. With these factors as reference points, one can describe lesions in the structure involved, the precise location and extent of the lesions, and the degree of structural compromise that is manifested. Documentation of lesions of tendons and ligaments enables one to make an accurate diagnosis and a more precise prognosis. Serial examination during the healing phases allows for a more accurate prediction as to when the structure in question can withstand athletic challenge.

Diagnostic ultrasonography of equine limbs.

In our 3 years of clinical experience, we have found that diagnostic ultrasound provides the veterinarian with a valuable diagnostic tool. It allows the clinician to quantify morphologic change that has occurred as a result of soft-tissue injuries, even when the clinical findings are ambiguous or insufficient. In cases in which aggressive postinjury therapy has been instituted prior to presentation, diagnostic ultrasound is often the only noninvasive method that can ascertain the extent of the horse's injury. Diagnostic ultrasound provides the technology to detect injuries before they become permanently debilitating, because lesions as small as 1 mm in diameter can be detected. Prior to diagnostic ultrasound, the severity of many injuries was underestimated. In such cases, if the horse responded favorably to symptomatic therapy, the client would resume training. The result was often debilitation. Diagnostic ultrasound also enables the clinician to demonstrate visually to the client the location, size, and extent of lesions in the limb. One of the more gratifying effects of a sonographic study is the client's acceptance of the presence and extent of the injury after visualizing it. We have found that the old adage "a picture is worth a thousand words" is generally the rule in obtaining the proper course of therapy for the horse. The ability to make hard copies of sonograms enables the clinician to morphologically evaluate the rate of healing. He can accurately determine the effectiveness of a therapeutic regimen and ascertain when optimal healing has occurred. Diagnostic ultrasound can provide the researcher with an invaluable tool to document and quantify soft-tissue disease. We anticipate that, in the future, the sonographic appearance of recovered tissues will be correlated with new data on the healing process and the effectiveness of various therapies. The material presented above has covered the value of diagnostic ultrasound in major clinical situations related to equine lameness. Other applications, the discussion of which is beyond the scope of this article, include evaluation of the pastern for injuries to the SDF, DDF, and oblique sesamoidean ligament, and evaluation of the navicular bursae. Examination of muscles for hematomas, abscessations, and tears has also been accomplished ultrasonographically. Diagnostic ultrasound has facilitated study of the trochanteric and bicipital bursae, blood flow through arteries, and structures above the carpus and hock. Obviously, the clinical potential of diagnostic ultrasound is limitless.(ABSTRACT TRUNCATED AT 400 WORDS)

Proper identification of anisakine worms.

Luminal, gastric, intestinal and mesenteric forms of anisakiasis are known and can be encountered where raw or undercooked marine fish or squid are eaten. Although the anisakine nematodes which cause infection in humans are usually identified after surgical removal, laboratory personnel should be aware of their similarities to other nematodes. Cases have been reported of detection of larval nematodes in the throats or mouths of patients who have vomited or coughed. When such specimens are submitted to the clinical laboratory, problems in identification can be minimized by proper fixation and clearing. Systems for study involving clearing in phenol-ethanol and dissection to observe presence or absence of a ventricular appendix or intestinal cecum to distinguish Anisakis-, Phocanema- and Contracaecum-type larvae are described. Distinguishing characteristics are illustrated. The recovery of a Phocanema-type larva from a California woman is reported; the presence of the larvae in fish sold for human consumption in San Diego is exemplified.