Dissociative anaesthesia in dogs and cats with use of tiletamine and zolazepam combination. What we already know about it.

This article is an attempt to gather available literature regarding the use of tiletamine and zolazepam combination in anaesthesia in dogs and cats. Although tiletamine and zolazepam mixture has been known in veterinary practice for a long time, the increased interest in these drugs has been observed only recently. Tiletamine, similarly to ketamine, is a drug which belongs to the phencyclidine group. Ketamine has considerable popularity in veterinary practice what suggests that other dissociative anaesthetic drugs, such as tiletamine, could also prove effective in cats' and dogs' anaesthetic care. Zolazepam is a widely used benzodiazepine known for its muscle relaxant and anticonvulsant properties. While conducting an electronic search for articles regarding the use of tiletamine-zolazepam combination in dogs and cats, it has been discovered that the literature on the subject (tiletamine-zolazepam combination in dogs and cats) is quite scarce. Very few articles were published after 2010. Databases used were: Google Scholar, Scopus, PubMed. Most of the adverse effects, including those affecting the cardiovascular, nervous, and respiratory systems, were strictly dose-dependent. Tiletamine-zolazepam combination can be safely used as a premedication agent, induction for inhalation anaesthesia, or an independent anaesthetic for short procedures. Contraindications using tiletamine-zolazepam mixture include central nervous system (CNS) diseases such as epilepsy and seizures, head trauma, penetrative eye trauma, cardiovascular abnormalities (hypertrophy cardiomyopathy in cats, arrythmias or conditions where increase of heart rate is inadvisable), hyperthyroidism, pancreatic deficiencies or kidney failure.

The volume of unilaterally undescended testis after hCG therapy compared to orchidopexy and combined methods.

The aim of the study was to compare the effects of human chorionic gonadotropin (hCG) therapy with those of surgical or combined therapy on testicular volume (TV) in boys at different ages with unilateral canalicular undescended testis (UDT). In total, 155 boys aged 1 to 12 years were treated: either surgically (ST), or by 50 IU/kg body weight hCG administration every three days for five weeks (HT), or by a combination of the two. The patients underwent ultrasound examination of TV before the treatment, 9-12 (median 10) and 24-39 months (median 32) after therapy. The testicular atrophy index (TAI) of the affected testicle was calculated. The success rate was 94.7% for ST, 39.2% for HT and 98% for HST patients. The atrophy rate was 5.3% for ST, 0% for HT and 2% for HST. Neither treatment type nor patient age significantly influenced gonadal atrophy. No significant differences in TV of the affected testis were observed after treatment between the groups. The TAI values were significantly the lowest in HT group (p = 0.0006). Both TV and TAI changes from the baseline values did not differ between the treatment groups. At the 24- to 39-month follow-up, no significant differences were observed in the change in baseline TV and baseline TAI between age groups. TV of the affected testis increased significantly (p = 0.0000), and TAI decreased significantly over time (p = 0.01), with no significant differences depending on the age group, treatment type or the interaction of the two factors. The hCG therapy did not impair the development of affected and healthy testes, neither as single nor as neoadjuvant therapy, both during early assessment and after 2-3 years. Patients' age at the initiation of treatment seems irrelevant.

[Effect of cigarette smoking on carbohydrate metabolism of healthy subjects]. / Wplyw palenia papierosów na przemiane weglowodanowa u osób zrowych.

UNLABELLED: Serum levels of triglycerides (TG), cholesterol (CH), total lipids (LP), beta-lipoproteids (B-LP), basal glucose and immunoreactive insulin were assessed in 23 healthy subjects (12 non-smokers and 11 smokers). Influence of smoking cigarettes on level of glycemia and insulin secretion in basal conditions and 30, 60, 90 and 120 minutes after load of 75 g glucose. Concentration of glucose was measured by an enzymatic method and level of IRI by radioimmunoassay. Smokers differed from non-smokers in significantly higher diastolic blood pressure and non-significantly higher concentration of TG, CH, LP, B-LP. No statistically significant difference in basal glucose level and profile of glycemia were found between both groups. Significantly higher basal level of insulinemia and increased secretion of insulin after an oral glucose tolerance test were observed in comparison with non-smokers. CONCLUSIONS: 1) The significant higher level of serum basal IRI was found in smokers when compared to non-smokers. 2) Results suggest non-effective hyperinsulinemia in people smoking cigarettes.

Radiology of cholecystectomy complications.

Postoperative problems following simple removal of the gallbladder are infrequent. Radiographic studies may be valuable in suggesting or confirming the diagnosis when not clinically evident. Plain films, contrast studies, ultrasound, and computed tomography (CT) all can be useful modalities in this area. Several examples of complications related specifically to the operative field in cholecystectomy are reviewed.

Ectopic gallstone as a cause of gastric outlet obstruction.

Gallstone ileus is, of course, a well known cause of small bowel obstruction. A gallstone, however, is a very rare cause of gastric outlet obstruction. Three cases illustrating this phenomenon are exhibited. Radiographs were diagnostic in two of the studies. All three patients did well postoperatively.