Ultrasonography criteria for differentiating ACTH dependency from ACTH independency in 47 dogs with hyperadrenocorticism and equivocal adrenal asymmetry.

Background: Adrenal ultrasonography (US) in dogs with hyperadrenocorticism (HAC) is commonly used to distinguish adrenocorticotropic hormone (ACTH)-independent (AIHAC) and ACTH-dependent hyperadrenocorticism (ADHAC). To date, no cut-off values for defining adrenal atrophy in cases of adrenal asymmetry have been determined. Given that asymmetrical hyperplasia is sometimes observed in ADHAC, adrenal asymmetry without ultrasonographic proof of adrenocortical tumor such as vascular invasion or metastasis can be equivocal.

A global view of education and training in critical care medicine.

The Educational Committee of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) performed a survey in various countries and reviewed data from the Cobatrice study and from surveys of the Pan-American and Iberic Federation of Societies of Intensive and Critical Care Medicine to characterize current structures and processes in education in intensive care medicine to determine the potential for convergence to a common competency-based training program, and to a common competency certification in most countries around the world, guided by the local scientific societies and the WFSICCM. Training in critical care medicine sponsored by the WFSICCM should provide a competency approach that permits diversity of training methods while creating a common outcome: doctors with a universal set of knowledge, skills, and attitudes essential for a specialist in intensive care medicine.

Global distribution of infectious diseases requiring intensive care.

This article describes infectious diseases that are of special importance to intensivists. The emphasis on epidemiology notwithstanding, it also addresses clinical, diagnostic, and treatment issues related to each infection described. The discussion avoids terrorism-related aspects of these infections, because they were very well covered in the October 2005 issue of the Critical Care Clinics.

First human case of retrograde transcatheter implantation of an aortic valve prosthesis.

The transcatheter route is an emerging approach to treating valvular disease in high-risk patients. The 1st clinical antegrade transcatheter placement of an aortic valve prosthesis was reported in 2002. We describe the first retrograde transcatheter implantation of a new aortic valve prosthesis, in a 62-year-old man with inoperable calcific aortic stenosis and multiple severe comorbidities.

Significance of a common extended mucosal interface observed in transverse small intestine sonograms.

An echogenic stripe can be seen through the mucosal layer on either side of the ultrasonographic image of a bowel loop in cross-section. The mucosa is a continuous layer surrounding the intestinal lumen; thus it should appear as a continuous hypoechoic band with no bright stripe in it. The purpose of this study was to investigate the origin of this stripe and to determine whether it is an artifact.

Passive liver congestion associated with caudal vena caval compression due to oesophageal leiomyoma.

A large caudodorsal mediastinal mass was identified in a dog which had been presented for vomiting and anorexia. A few weeks later, the dog developed ascites and hindlimb oedema. Radiography showed that the caudodorsal mediastinal mass was compressing the caudal vena cava, probably inducing passive congestion of the liver.

Emphysematous pyometra in a dog.

An 8-year-old intact female West Highland White Terrier was examined for anorexia, vomiting, abdominal distension, and mild purulent vulvar discharge. The results of physical examination, laboratory testing, and radiography are presented. Emphysematous pyometra was suspected and confirmed at surgery.

Pericardial effusion and pericardiocentesis in a guinea pig (Cavia porcellus).

A three-year-old, female guinea pig (Cavia porcellus) presented for acute dyspnea and weakness. Radiographs and echocardiography were consistent with a diagnosis of pericardial effusion and heart failure secondary to cardiac tamponade. Ultrasound-guided pericardiocentesis was performed, and clinical signs rapidly improved.

Retrospective review of the ultrasonographic features of adrenal lesions in 21 ferrets.

Clinical signs and follow-up information were recorded. Histopathologic diagnoses were obtained for 25 adrenal glands in 21 ferrets. Adrenal lesions included ten adenocarcinomas, nine adenomas, one hyperplasia and one cortical cyst.

Ultrasonographic appearance and clinical findings in 14 dogs with gallbladder mucocele.

Fourteen dogs with enlarged gallbladders and immobile stellate or finely striated bile patterns on ultrasound are described. Smaller breeds and older dogs were overrepresented, with 4/14 Cocker Spaniels. Most dogs presented for nonspecific clinical signs such as vomiting, anorexia and lethargy.

Evaluation of joint stabilization for treatment of shearing injuries of the tarsus in 20 dogs.

Medical records of 20 dogs with 23 shearing injuries of the tarsus leading to joint instability were reviewed. A transarticular external skeletal fixation device or prosthetic ligament was used to stabilize the joints. The most common complications were fixator failure and implant infection.

Retrospective ultrasonographic evaluation of adrenal lesions in 26 dogs.

A review was performed of ultrasonographic findings in 26 dogs with confirmed adrenal lesions. Adrenal shape, size, echogenicity, laterality, and the presence of vascular invasion were evaluated. Histopathologic diagnoses were obtained in all dogs.

Imaging of adrenal gland disorders.

In recent years, diagnostic imaging has become an important adjunct to conventional endocrine testing in the evaluation of adrenal gland dysfunction. This article discusses the role of imaging in the diagnostic workup of the following adrenal gland disorders: hypercatacholaminism, hyperaldosteronism, hyperadrenocorticism, and hypoadrenocorticism. The strengths and limitations of radiography, ultrasonography, scintigraphy, CT scanning, and MR imaging are addressed.

Blood volume following diuresis induced by furosemide.

Changes in blood volume were investigated following intravenous injection of a single dose of furosemide in 21 patients with pulmonary edema. In a subset of 10 patients in whom the blood urea nitrogen level was 11.4 +/- 2.

[Our experience with bronchofibroscopy].

Five hundred and eighty three broncho-fibroscopies were performed by the authors. Tumoural pathology represents 60% of diagnostic indications. Histological samples have a satisfying yield : 72.