A practical review of small intestinal anastomosis for the small animal practitioner

2021 ◽  
Vol 26 (1) ◽  
pp. 1-7
Author(s):  
Ilaria Caruso ◽  
Jon Hall
Keyword(s):  
Best Practice ◽  
Intestinal Anastomosis ◽  
Small Animal ◽  
Learning Objectives ◽  
Evidence Based ◽  
Small Animals ◽  
Intestinal Surgery ◽  
Improve Outcome ◽  
Patient Morbidity ◽  
Small Intestinal

Dehiscence following intestinal surgery results in significant patient morbidity and mortality. Thorough knowledge and application of modern evidence-based principles relating to the procedures of enterotomy and enterectomy with anastomosis can significantly reduce the risk of postoperative complications in small animals. This article will review some of the potential causes of intestinal dehiscence and reflect on best practice surgical principles, highlighting particularly important key learning objectives to improve outcome.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

Recommendations for Intensive Care Management in Small Animals Following Anaesthesia

1992 ◽  
Vol 05 (02) ◽  
pp. 66-70
Author(s):  
Karol Mathews ◽  
Doris Dyson
Keyword(s):  
Intensive Care ◽  
Care Management ◽  
Small Animal ◽  
Small Animals ◽  
Monitoring Equipment ◽  
Intensive Care Management ◽  
Good Communication

Intensive care management can be provided in a small animal facility by centralisation of emergency and monitoring equipment. Good communication between all personnel involved in the case ensures that staff are prepared for complications that could arise related to recovery from anaesthesia.

The use of the objective structured clinical examination (OSCE) in a practice-based health discipline: Academic and student experience in paramedicine

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Andy Bell ◽  
Jennifer Kelly ◽  
Peter Lewis
Keyword(s):  
Clinical Examination ◽  
Best Practice ◽  
Assessment Tool ◽  
Clinical Performance ◽  
Reliability And Validity ◽  
Specific Area ◽  
Training Model ◽  
Objective Structured Clinical Examination ◽  
Evidence Based ◽  
Effective Measure

Abstract:Purpose:Over the past two decades, the discipline of Paramedicine has seen expediential growth as it moved from a work-based training model to that of an autonomous profession grounded in academia.  With limited evidence-based literature examining assessment in paramedicine, this paper aims to describe student and academic views on the preference for OSCE as an assessment modality, the sufficiency of pre-OSCE instruction, and whether or not OSCE performance is a perceived indicator of clinical performance.Design/Methods:A voluntary, anonymous survey was conducted to examine the perception of the reliability and validity of the Objective Structured Clinical Examination (OSCE) as an assessment tool by students sitting the examination and the academics that facilitate the assessment. Findings:The results of this study revealed that the more confident the students are in the reliability and validity of the assessment, the more likely they are to perceive the assessment as an effective measure of their clinical performance.  The perception of reliability and validity differs when acted upon by additional variables, with the level of anxiety associated with the assessment and the adequacy of feedback of performance cited as major influencers. Research Implications:The findings from this study indicate the need for further paramedicine discipline specific research into assessment methodologies to determine best practice models for high quality assessment.Practical Implications:The development of evidence based best practice guidelines for the assessment of student paramedics should be of the upmost importance to a young, developing profession such as paramedicine.Originality/Value: There is very little research in the discipline specific area of assessment for paramedicine and discipline specific education research is essential for professional growth.Limitations:The principal researcher was a faculty member of one of the institutions surveyed.  However, all data was non identifiable at time of data collection.  Key WordsParamedic; paramedicine; objective structured clinical examinations; OSCE; education; assessment.

American Academy of Otolaryngology–Head and Neck Surgery/Foundation Reg-ent Registry: Purpose, Properties, and Priorities

2021 ◽  
pp. 019459982098413
Author(s):  
Cecelia E. Schmalbach ◽  
Jean Brereton ◽  
Cathlin Bowman ◽  
James C. Denneny
Keyword(s):  
American Academy ◽  
Head And Neck ◽  
Best Practice ◽  
Medical Center ◽  
Quality Care ◽  
Academic Medical Center ◽  
Neck Surgery ◽  
Performance Measure ◽  
Head And Neck Surgery ◽  
Evidence Based

Objective (1) To describe the patient and membership cohort captured by the otolaryngology-based specialty-specific Reg-ent registry. (2) To outline the capabilities of the Reg-ent registry, including the process by which members can access evidence-based data to address knowledge gaps identified by the American Academy of Otolaryngology–Head and Neck Surgery/Foundation and ultimately define “quality” for our field of otolaryngology–head and neck surgery. Methods Data analytics was performed on Reg-ent (2015-2020) Results A total of 1629 participants from 239 practices were enrolled in Reg-ent, and 42 health care specialties were represented. Reg-ent encompassed 6,496,477 unique patients and 24,296,713 encounters/visits: the 45- to 64-year age group had the highest representation (n = 1,597,618, 28.1%); 3,867,835 (60.3%) patients identified as Caucasian; and “private” was the most common insurance (33%), followed by Blue Cross/Blue Shield (22%). Allergic rhinitis–unspecified and sensorineural hearing loss–bilateral were the top 2 diagnoses (9% each). Overall, 302 research gaps were identified from 17 clinical practice guidelines. Discussion Reg-ent benefits are vast—from monitoring one’s practice to defining otolaryngology–head and neck surgery quality, participating in advocacy, and conducting research. Reg-ent provides mechanisms for benchmarking, quality assessment, and performance measure development, with the objective of defining and guiding best practice in otolaryngology–head and neck surgery. To be successful, patient diversity must be achieved to include ethnicity and socioeconomic status. Increasing academic medical center membership will assist in achieving diversity so that the quality domain of equitable care is achieved. Implications for Practice Reg-ent provides the first ever registry that is specific to otolaryngology–head and neck surgery and compliant with HIPAA (Health Insurance Portability and Accountability Act) to collect patient outcomes and define evidence-based quality care.

Serum cobalamin concentrations and small intestinal ultrasound changes in 75 cats with clinical signs of gastrointestinal disease: a retrospective study

2016 ◽  
Vol 19 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Maria C Jugan ◽  
John R August
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Disease ◽  
Clinical Signs ◽  
Small Animal ◽  
Abdominal Ultrasound ◽  
Wall Layer ◽  
Normal Serum ◽  
Definitive Diagnosis ◽  
Albumin Concentration ◽  
Small Intestinal

Objectives The aim of the study was to evaluate ultrasonographic changes in the small intestine of cats with clinical signs of gastrointestinal disease and low or low–normal serum cobalamin concentrations. Methods Records for client-owned cats presenting to the small animal hospital with signs of gastrointestinal disease and in which serum cobalamin concentrations were measured from 2000–2013 were reviewed. Inclusion criteria were cobalamin concentrations <500 ng/l, abdominal ultrasound within 1 month of cobalamin testing and definitive diagnosis. Results Of 751 serum cobalamin measurements, hypocobalaminemia or low–normal cobalamin was identified in 270 cats, abdominal ultrasound was performed in 207 of those cats and a diagnosis was available for 75 of them. Small intestinal ultrasound changes were detected in 49/75 (65%) cats. Abnormalities included thickening, loss of wall layer definition, echogenicity alterations and discrete masses. Serum cobalamin concentrations <500 ng/l were observed with diagnoses of inflammatory disease, neoplasia, infectious disease and normal histopathology. Cobalamin concentration was significantly lower in cats with lymphoma or inflammatory bowel disease compared with other gastrointestinal neoplasia ( P = 0.031). No difference was found between cobalamin concentration and the presence of ultrasound abnormalities, specific ultrasound changes or albumin concentration. Conclusions and relevance One-third of symptomatic cats with hypocobalaminemia or low–normal cobalamin concentrations may have an ultrasonographically normal small intestine. For the majority of cats in this study, histopathologic abnormalities were observed in the small intestine, regardless of ultrasound changes. These findings suggest gastrointestinal disease should not be excluded based on low–normal cobalamin concentrations, even with a concurrent normal ultrasound examination. Additional studies are needed in cats with low–normal serum cobalamin concentrations, as a definitive diagnosis was not pursued consistently in those cats. However, data from this study suggest that careful monitoring, histopathologic evaluation and future cobalamin supplementation may be warranted.

Small intestinal surgery 2. techniques

In Practice ◽  
2000 ◽  
Vol 22 (10) ◽  
pp. 574-592
Author(s):  
Stephen Baines
Keyword(s):  
Intestinal Surgery ◽  
Small Intestinal

EMPTY BODY WEIGHTS, CARCASS WEIGHTS AND OFFAL PROPORTIONS IN BULLS AND STEERS OF DIFFERENT MATURE SIZE

1984 ◽  
Vol 64 (1) ◽  
pp. 53-57 ◽  
Author(s):  
S. D. M. JONES ◽  
R. E. ROMPALA ◽  
J. W. WILTON ◽  
C. H. WATSON
Keyword(s):  
Body Weight ◽  
Small Animal ◽  
High Energy ◽  
Carcass Weight ◽  
Small Animals ◽  
Beef Steers ◽  
Body Weights ◽  
Breed Crosses ◽  
Large Animals ◽  
Animal Size

Empty body weights, carcass weights and offal proportions were compared in 33 young beef bulls and 33 beef steers of different mature body size (35 small or mainly British breed crosses, 31 large or Continental crosses). All cattle were fed a high energy diet based on corn silage and high moisture corn from weaning to slaughter. Slaughter was carried out once 6 mm of fat had been attained at the 11/12th ribs, determined ultrasonically. Feed was removed 24 h and water 16 h prior to slaughter. The offal components were all weighed fresh and the alimentary components emptied of digesta. Bulls weighed 8.0% heavier (P < 0.05) than steers at slaughter, while large animals were 38.7% heavier (P < 0.0001) than small animals. Bulls and large animals had carcasses that dressed out 1.5% heavier than steers and small animals. To eliminate the effect of gutfill, carcass weights and offal components were expressed as a proportion of empty body weight. Bulls had a higher proportion of warm carcass weight and lower proportions of liver, spleen, heart, lungs, rumen, abomasum, large intestine and front feet relative to empty body weight than steers. Large animals had a greater proportion of warm carcass weight and hind feet, and a lower proportion of head, hide, liver, kidneys, omasum and small intestine relative to empty body weight than small animals. All castration by size interactions for liveweight, carcass weight, empty body weight and offal proportions were not significant. Castration and small animal size both increased the proportion of noncarcass parts relative to empty body weight in animals slaughtered at similar finish. Key words: Body, carcass, offal, bull, steer, maturity

When a Baby Is Sent Away: Evidence to Support Best Practice After Neonatal Transport

2018 ◽  
Vol 37 (3) ◽  
pp. 178-181
Author(s):  
Sabrina Schwartz ◽  
Deborah A. Raines
Keyword(s):  
Best Practice ◽  
Care Center ◽  
Bonding Process ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Neonatal Transport ◽  
Child Relationship ◽  
The Hours ◽  
Mother Child Relationship

Every day neonates are transported from the birth hospital to a tertiary neonatal care center. Separation of mother and neonate in the hours immediately following birth interrupts the bonding process and can have long-term implications for the mother–child relationship. This article synthesizes the literature focused on mothers’ experiences with a neonate being transported to a tertiary NICU and identifies evidence-based practices specific to these situations.

Use of the Leksell Gamma Knife for Localized Small Field Lens Irradiation in Rodents

2003 ◽  
Vol 2 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Colleen DesRosiers ◽  
Marc S. Mendonca ◽  
Craig Tyree ◽  
Vadim Moskvin ◽  
Morris Bank ◽  
...  
Keyword(s):  
Gamma Knife ◽  
High Precision ◽  
Small Animal ◽  
Small Animals ◽  
Small Field ◽  
Thermoluminescent Dosimeters ◽  
Ion Chamber ◽  
Order Of Magnitude ◽  
Contralateral Eye

For most basic radiobiological research applications involving irradiation of small animals, it is difficult to achieve the same high precision dose distribution realized with human radiotherapy. The precision for irradiations performed with standard radiotherapy equipment is ±2 mm in each dimension, and is adequate for most human treatment applications. For small animals such as rodents, whose organs and tissue structures may be an order of magnitude smaller than those of humans, the corresponding precision required is closer to ±0.2 mm, if comparisons or extrapolations are to be made to human data. The Leksell Gamma Knife is a high precision radiosurgery irradiator, with precision in each dimension not exceeding 0.5 mm, and overall precision of 0.7 mm. It has recently been utilized to treat ocular melanoma and induce targeted lesions in the brains of small animals. This paper describes the dosimetry and a technique for performing irradiation of a single rat eye and lens with the Gamma Knife while allowing the contralateral eye and lens of the same rat to serve as the “control”. The dosimetry was performed with a phantom in vitro utilizing a pinpoint ion chamber and thermoluminescent dosimeters, and verified by Monte Carlo simulations. We found that the contralateral eye received less than 5% of the administered dose for a 15 Gy exposure to the targeted eye. In addition, after 15 Gy irradiation 15 out of 16 animals developed cataracts in the irradiated target eyes, while 0 out of 16 contralateral eyes developed cataracts over a 6-month period of observation. Experiments at 5 and 10 Gy also confirmed the lack of cataractogenesis in the contralateral eye. Our results validate the use of the Gamma Knife for cataract studies in rodents, and confirmed the precision and utility of the instrument as a small animal irradiator for translational radiobiology experiments.

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