Clinical findings and prognostic factors for immediate survival in 33 dogs undergoing surgery for biliary peritonitis.

Objective: To report demographics, clinical signs, physical examination, diagnostic test results, surgical findings, and prognostic factors for in-hospital postoperative mortality following biliary peritonitis surgery in dogs.

Study Design: Retrospective, multi-institutional cohort study.

Animals: Thirty-three client-owned dogs.

Pilot cadaveric study on the feasibility of cricothyroidotomy and the associated complications in 30 cats.

Objectives: The study's primary goal was to assess the feasibility of the cricothyroidotomy technique (CTT) in cats and evaluate its success rate (i.e., secure airway access).

Management of a severe peripartum hemorrhage following cesarean section in a dog.

This report describes the intensive blood pressure management and transfusion of a peripartum intrauterine hemorrhage following a cesarean section in a dog. The impact of pregnancy-associated physiologic changes and anesthesia on hemodynamic parameters along with potential alternate management techniques are discussed.

Bile composition of healthy cats and cats with suspected hepatobiliary disease using point-of-care analyzers: A prospective preliminary study.

Although hepatobiliary disease is common in cats, little is known about the bile composition in either these diseased states or in healthy cats. The objectives of this study were to evaluate several analytes from the bile of healthy cats and to investigate the usefulness of measuring these variables to predict bacterial cholangitis. Cats were prospectively enrolled and divided into 3 groups: 21 healthy cats (group 1) and 14 cats with suspected hepatobiliary disease: 9 without bacterial biliary infection (group 2) and 5 with bacterial biliary infection (group 3).

Prevalence and management of pain in dogs in the emergency service of a veterinary teaching hospital.

A prospective, observational, cross-sectional study documenting the prevalence of pain in dogs presented to the emergency service of a veterinary teaching hospital and their handling (times to triage, examination, treatment) was conducted. Pain was assessed and compared using a validated and an unvalidated pain assessment scale. Sedation was monitored using a validated scale.

Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale.

Grimace scales have been used for pain assessment in different species. This study aimed to develop and validate the Feline Grimace Scale (FGS) to detect naturally-occurring acute pain. Thirty-five client-owned and twenty control cats were video-recorded undisturbed in their cages in a prospective, case-control study.

Systemic disseminated infection with cutaneous lesions as the initial clinical presentation in a dog.

This report describes a disseminated infection with cutaneous involvement as the primary presenting clinical sign, in an apparently immunocompetent 7-year-old, spayed female boxer dog. The dog had an 8-day history of progressive lethargy associated with the appearance of multiple cutaneous and ulcerated masses, followed by an acute deterioration of her clinical status. Blood analysis revealed thrombocytopenia, increased liver enzyme activity, and partial thromboplastin time.

The Will Reconsidered: Hard Choices in Living Organ Donation.

In the following article, we illustrate an interview between a living donor advocate and a potential living organ donor in which the donor faced a hard choice: the reasons to donate and the reasons not to donate were equally persuasive. In the discussion that follows, we analyze the act of willing, what differentiates coercion and willing, and how the case study highlights a different, but by no means rare, instance in which donors feel paralyzed by the choice at hand. In such cases, we suspect that donor advocates either do not approve the potential donor for transplantation or simply remain neutral.

Chylous ascites associated with abdominal trauma and intestinal resection-anastomosis in a pet ferret (Mustela putorius furo).

CASE DESCRIPTION A 10-week-old 0.73-kg (1.6-lb) castrated male domestic ferret (Mustela putorius furo) was referred for exploratory laparotomy because of pneumoperitoneum and possible septic peritonitis after being bitten by the owner's dog.

On Truthful Introductions.

This article was migrated. The article was marked as recommended. None.

Complexity Analysis of Decision-Making in the Critically Ill.

Rationale: Despite multiple trials of interventions to improve end-of-life care of the critically ill, there is a persistent lack of understanding of factors associated with barriers to decision-making at the end of life.

Objective: To apply the principles of complexity science in examining the extent to which transitions to end-of-life care can be predicted by physician, family, or patient characteristics; outcome expectations; and the evaluation of treatment effectiveness.

Methods: A descriptive, longitudinal study was conducted in 3 adult intensive care units (ICUs).

Cancer patient age and family caregiver bereavement outcomes.

Purpose: This study drew on life course theory to argue that the strains of cancer caregiving and bereavement are modified by the age of the patient. We expected that caregivers of middle-aged patients would be more distressed than caregivers of older patients.

Methods: This panel study conducted 199 interviews with family caregivers of advanced cancer patients; first following diagnosis and again shortly after the patient's death.

Coexistent arteriovenous malformation and hippocampal sclerosis.

Cavernous angiomas or cavernomas have been occasionally described in patients presenting with medically intractable epilepsy. Reports of cavernomas associated with a second pathology potentially causative of seizures have rarely been documented; most commonly, the second pathology is focal cortical dysplasia or less frequently, hippocampal sclerosis. To our knowledge, cases of arteriovenous malformation arising in this clinical setting and associated with hippocampal sclerosis have not been previously described.

Grief and risk of depression in context: the emotional outcomes of bereaved cancer caregivers.

We investigated the relationships of grief and depression to cancer caregiving in early bereavement. We began with three expectations: (a) each outcome would reflect different situational predictors, (b) grief would be more directly related to such predictors, and (c) components of grief would relate differently to the caregiving context and depressed mood. We conducted telephone interviews with family caregivers of incurable cancer patients from two hospitals.

Preferences for aggressive care in underserved populations with advanced-stage lung cancer: looking beyond race and resuscitation.

Purpose: This paper examines the relationship between race, religiousness, spiritual well-being, antitumor treatment and preference for aggressive care among Black and White patients with advanced stage lung cancer receiving ambulatory cancer care in an urban setting.

Methods: A cross-sectional exploration of patients enrolled in a Cleveland-based longitudinal study after initial diagnosis of advanced lung cancer were interviewed in Cleveland regarding religiousness, spiritual well-being, preferences for cardiopulmonary resuscitation (CPR), goals of aggressive care, and willingness to tolerate adverse health states. Receipt of antitumor treatment was identified from medical records.

Effect of a computerized brain exercise program on cognitive performance in older adults.

Objectives: Research indicates an association between stimulating mental activities and better memory performance as people age, but studies on computerized mental stimulation programs are limited. We explored whether computerized brain training exercises improved cognitive performance in older adults.

Methods: In local retirement communities, a convenience sample was randomized into an intervention group (N = 36), who used a computer program 5 days a week for 20-25 minutes each day, or a wait-list control group (N = 33).

Community-based participatory development of a community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans.

Objectives: The REACH NOLA Mental Health Infrastructure and Training Project (MHIT) aimed to reduce disparities in access to and quality of services for depression and posttraumatic stress disorder (PTSD) in post-Katrina New Orleans by developing a mental health outreach role for community health workers (CHWs) and case managers as a complement to the collaborative care model for depression treatment.

Intervention: Community agency leaders, academics, healthcare organizations, and CHWs engaged in a community participatory process to develop a CHW training program.

Design: A review of qualitative data including semi-structured interviews, project team conference calls, email strings, and meeting minutes was conducted to document CHW input into training and responses to implementation.

Primary care physicians' involvement in the cancer care of older long-term survivors.

Objective: This study investigated survivors' reports of primary care physicians' (PCPs) involvement in three key cancer survivorship activities: discussing cancer history, whether the PCP initiated discussions, and whether discussions led to tests/procedures.

Method: The sample included 215 older survivors whose health care was maintained in primary care. Logistic regression explored predictors of the three activities, including demographics, cancer characteristics, survivor/PCP association characteristics, health characteristics, and psychosocial well-being.

Effectiveness trial of an intensive communication structure for families of long-stay ICU patients.

Background: Formal family meetings have been recommended as a useful approach to assist in goal setting, facilitate decision making, and reduce use of ineffective resources in the ICU. We examined patient outcomes before and after implementation of an intensive communication system (ICS) to test the effect of regular, structured formal family meetings on patient outcomes among long-stay ICU patients.

Methods: One hundred thirty-five patients receiving usual care and communication were enrolled as the control group, followed by enrollment of intervention patients (n = 346), from five ICUs.

Predictors of engagement in a coping and communication support intervention for older patients with advanced cancer.

Objectives: To examine patterns and predictors of engagement in a coping and communication support (CCS) intervention tailored to the preferences of middle-aged and older patients in the early treatment phase for late-stage cancer.

Design: Randomized controlled trial examining processes and outcomes of a CCS intervention for patients with late-stage cancer over time.

Setting: Two ambulatory cancer clinics providing care for underserved populations in Cleveland.

The role of primary care physicians in advanced cancer care: perspectives of older patients and their oncologists.

Objectives: To examine data from advanced cancer patients and their oncologists regarding patient age-related differences in patient and oncologist perspectives on involvement of primary care physicians (PCPs) in aspects of cancer management.

Design: Randomized controlled trial of a support intervention for patients with late-stage cancer treated in two teaching hospital-based cancer clinics caring for underserved populations.

Participants: Three hundred fifty-seven patients who had an oncologist and PCP enrolled 2 to 3 months after an advanced cancer diagnosis.

Changing healthcare practice for older adults with late-stage non-small cell lung cancer: practical considerations of targeted therapy in primary care and oncology.

Healthcare practice for cancer care is rapidly evolving because of advances in technology, scientific discovery, drug development, and aging demographics in America. Among the substantive changes in science and drug development is targeted therapy. Targeted agents are changing the scope of practice in treating lung cancer-the leading cause of cancer death in older adults.

Geriatric oncology and primary care: promoting partnerships in practice and research.

This supplement is a compilation of original work that was presented at an interdisciplinary conference on "Geriatric Oncology and Primary Care: Promoting Partnerships in Practice and Research" held in Cleveland, Ohio, April 3 to 4, 2008. An audience of 77 clinicians and researchers attended this conference, primarily coming from Ohio and adjacent states. Articles are organized around a conceptual framework to consider primary and shared care roles of primary care physicians (PCPs) and oncologists in the care of older patients with cancer and their families.