Intraluminal hemorrhage from small intestinal ulceration in two cows.

Two adult Holstein cows were admitted with signs of acute gastrointestinal hemorrhage. Abomasal ulceration was diagnosed tentatively in both cows, but was later ruled out in 1 cow that had an abomasotomy performed through a right paramedian approach. Both cows failed to respond to treatment of blood loss and hypovolemic shock and became recumbent; one cow died and the other was euthanatized.

Nontraumatic acute anterior mediastinitis in two HIV-positive heroin addicts.

We present the cases of two young heroin addicts seropositive for HIV who had life-threatening spontaneous acute anterior mediastinitis due to Staphylococcus aureus. This was the consequence of the spreading to the mediastinum of an infection of the chest wall. Complete cure was achieved with antibiotics and surgical drainage.

Prospective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change.

Circuits on mechanical ventilators with cascade humidifiers are routinely changed every day or every other day, although humidifying cascades have been considered unlikely to increase the risk of respiratory infection because they do not generate aerosols. Moreover, changing ventilator tubings every 24 rather than every 48 h increases the risk of ventilator-associated pneumonia. To study the effects of ventilator circuit changes on the rate of nosocomial pneumonia and on patient and circuit colonization, 73 consecutive patients requiring continuous mechanical ventilation for more than 48 h were randomly assigned to either ventilator circuit changes every 48 h (Group 1, n = 38) or no change (Group 2, n = 35).

Hemodialysis for acute renal failure in patients with hematologic malignancies.

Objective: To assess the prognosis of patients with hematologic malignancies in acute renal failure who require hemodialysis.

Design: Retrospective study.

Setting: ICU.

Luminal glucose enhances transepithelial Na+ and fluid transports in rat lungs.

The effects of luminal glucose on transepithelial Na+ and fluid transports were investigated in rat lungs. Two preparations were used: isolated, perfused lungs and lungs in situ perfused with blood (cross-circulations), a situation more comparable to that existing in vivo. Unidirectional (efflux from air spaces, J(out)) and net (Jnet) Na+ fluxes and fluid absorption from air spaces were estimated in lungs filled with bicarbonate-buffered solutions containing 10 mmol/l of either mannitol, glucose or alpha-methyl-D-glucopyranoside, or 0.

Ileal diverticulum as a cause of chronic colic in a horse.

A 4-year-old Thoroughbred gelding with a history of chronic colic was referred for evaluation of signs of abdominal pain. Exploratory laparotomy revealed a diverticulum of the distal portion of the ileum located between the layers of the mesentery. The diverticulum was similar in location and appearance to acquired ileal diverticula described in human beings.

Effects of a histamine type-2 receptor antagonist (BMY-25368) on gastric secretion in horses.

The effects of a potent new histamine-2 (H2) receptor antagonist, BMY-25368, were studied on gastric acid secretion in 5 foals from which food was withheld. Doses of 0.02, 0.

Surgical treatment of a mural teat abscess in a cow.

A 6-year-old multiparous Holstein cow was admitted for evaluation of progressive milk flow obstruction of one quarter of the udder. Physical examination findings suggested the presence of a mural teat abscess. Ultrasonography substantiated the physical examination findings and delineated the extent of the lesion.

Erysipelothrix rhusiopathiae-induced septic arthritis in a calf.

A 14-week-old Holstein heifer with a 48-hour history of left tarsocrural joint effusion was referred for evaluation when lameness developed 24 hours after needle aspiration was attempted at the farm. Results of synovial fluid analysis were compatible with diagnosis of septic arthritis, and bacteriologic culture of the fluid yielded Erysipelothrix rhusiopathiae. The calf responded to tarsocrural joint lavage and penicillin G administration.

[Hyponatremia of acute pulmonary infections].

The mechanism of hyponatremia associated with pneumonia has been debated. In particular, the responsibility of inappropriate antidiuretic hormone secretion has been questioned. We have shown that inappropriate antidiuretic hormone secretion is a nearly constant finding during pneumonia and is roughly proportional to the extent of pneumonia.

Fiberoptic bronchoscopy in ventilated patients. Evaluation of cardiopulmonary risk under midazolam sedation.

One hundred seven acutely ill ventilated patients were prospectively studied to ascertain the severity and frequency of alterations in gas exchange and hemodynamic parameters during brief bronchoscopy. Sedation was performed using midazolam (0.1 mg/kg IV) without topical anesthesia.

Third-degree perineal lacerations and rectovestibular fistulae in cattle: 20 cases (1981-1988).

The case records of 20 cows with either a third-degree perineal laceration or rectovestibular fistula were reviewed to ascertain the signalment, history, treatment, and long-term result of treatment. Fifteen cows, including 10 first-calf cows, had third-degree perineal lacerations that occurred at calving. Surgery was done in 14 of 15 cows; 10 of the 14 (71%) remained fertile.

Does the stress of admission to an intensive care unit influence arginine vasopressin secretion and renal diluting ability?

The pathogenesis of excessive arginine vasopressin (AVP) release and hyponatraemia in euvolaemic intensive care unit (ICU) patients is poorly understood. Stress has frequently been proposed as a possible determinant, but its actual responsibility has not been adequately assessed. Therefore, water-load tests were prospectively performed in 11 patients admitted to the ICU for severe or potentially severe diseases, but who had no other condition which could result in excessive AVP release or impairment of renal diluting ability.

Intestinal atresia in calves: 22 cases (1978-1988).

A retrospective study of 22 calves afflicted with intestinal atresia was performed to determine typical signs of disease, treatment, and survival rate. All 22 calves, except 2 heifers with atresia ani and rectovaginal fistula, were examined when they were between 1 and 10 days old because of depression, anorexia, abdominal distention, and lack of feces. All calves had been observed to stand and suckle shortly after birth.

Tall T waves during metabolic acidosis without hyperkalemia: a prospective study.

The specific ECG characteristics of metabolic acidosis have not been satisfactorily defined in man. We addressed this question by prospectively studying 14 consecutive patients admitted with metabolic acidosis and without hyperkalemia. Arterial blood gas analysis and serum potassium determinations were performed during acidosis and after its correction.

Acute infectious pneumonia is accompanied by a latent vasopressin-dependent impairment of renal water excretion.

The mechanism of hyponatremia associated with pneumonia has not been definitely established. Moreover, renal water excretion was never systematically investigated in cases of pneumonia without hyponatremia. We therefore studied nine consecutive patients breathing spontaneously (nasal oxygen in five), with acute infectious pneumonia and normal plasma sodium concentration.

High inflation pressure pulmonary edema. Respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure.

The respective roles of high pressure and high tidal volume to promote high airway pressure pulmonary edema are unclear. Positive end-expiratory pressure (PEEP) was shown to reduce lung water content in this type of edema, but its possible effects on cellular lesions were not documented. We compared the consequences of normal tidal volume ventilation in mechanically ventilated rats at a high airway pressure (HiP-LoV) with those of high tidal volume ventilation at a high (HiP-HiV) or low (LoP-HiV) airway pressure and the effects of PEEP (10 cm H2O) on both edema and lung ultrastructure.

Colopexy of the equine large colon: comparison of two techniques.

A study was designed to evaluate 2 colopexy techniques (A and B) in 8 clinically normal horses to determine which technique would prevent recurrence of large-colon displacement and/or volvulus. For technique A, 35 cm of the lateral free band of the left ventral colon was sutured to the abdominal wall, 6 cm to the left of ventral midline. For technique B, the medial free band of the left ventral colon was sutured to the medial free band of the right ventral colon, and 8 cm of the lateral free band of the left ventral colon was sutured to the abdominal wall, 6 cm to the left of ventral midline.

Survival after a second episode of toxic epidermal necrolysis.

Toxic epidermal necrolysis resulting from severe hypersensitivity to medication has a reported mortality of up to 66%. A patient surviving two episodes with more than a 50% skin loss is unprecedented in the medical literature. Mortality has been associated with many factors, including delayed reepithelialization, persistent skin slough, coagulopathy, severe hypoproteinemia, and sepsis.

Improved operative exposure of infrapopliteal vessels in combined vascular and orthopedic injuries.

In a series of six patients, a single-bar anterior external fixator was used to treat combined vascular and orthopedic injuries of the leg. This method of external fixation facilitated operative vascular exposure without sacrificing bony stability or alignment. It may be the preferred method of external fixation for these complex injuries.