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A one-year-old French Bulldog was referred for the management of a severe form of pulmonary valve stenosis (PS) complicated by right-sided congestive heart failure. Echocardiography showed severe valvular PS with right ventricular concentric hypertrophy, dilatation and severe right atrial enlargement. A pulmonary balloon valvuloplasty (PBV) was performed with a balloon-to-pulmonary annulus ratio of 1.36. Echocardiography immediately after PBV showed a significant reduction in right atrial and ventricular size, improved opening and mobility of the pulmonary valve leaflets, and a 75% reduction in the pulmonary pressure gradient from 158 mmHg pre-operative to 40 mmHg post-operative. The dog recovered well from anesthesia, but 2 h later, it suddenly showed severe respiratory distress. Focus cardiac ultrasound showed increased left cardiac size with echocardiographic signs of high left ventricular filling pressure. Bedside lung ultrasound showed diffuse numerous-to-confluent B lines, compatible with a severe alveolar-interstitial syndrome. The dog was treated with furosemide, helmet continuous positive airway pressure, and then mechanical ventilation but without success. At post-mortem evaluation, histological examination of the lung showed diffuse, severe broncho-alveolar edema with mixed leukocyte, fibrin, and red blood cell infiltrate. Moreover, severe congestion and multifocal alveolar hemorrhages were evident. All findings were compatible with fatal acute lung injury after PBV secondary to pulmonary reperfusion-ischemia injury and increased pulmonary capillary hydrostatic pressure. Based on the present case, acute lung injury should be considered as a rare but serious complication of PBV. [ABSTRACT FROM AUTHOR]

In veterinary medicine, the radiographic assessment of right heart enlargement (RHE) is essentially subjective. The aim of this study was to evaluate the vertebral right heart index (VRHi) as a new quantitative radiographic method to detect RHE in dogs. This was a multicenter, retrospective, observational study, including dogs with RHE and control dogs. All dogs had to have a thoracic radiographic study and a complete echocardiography on the same day. Right heart enlargement was defined as the presence of right atrial enlargement, right ventricular enlargement, and/or hypertrophy based on echocardiography. For the radiographic study, all the radiographic views available for each case were considered for measurement: right lateral (RL), left lateral (LL), ventrodorsal (VD), and dorsoventral (DV). The VRHi was measured using LL, RL, VD, and DV views. A total of 204 dogs were included: 91 dogs with RHE and 113 control dogs. The VRHi (RL), the VRHi (LL), and the VRHi (VD) were significantly greater in dogs with RHE compared with controls (P < .0001). The best diagnostic accuracy was observed for VRHi (LL) (area under the curve [AUC] 0.86, P < .0001; cutoff ≥ 3.5 vertebrae, sensitivity [Se] 71%, specificity [Sp] 89%), followed by VRHi (RL) (AUC 0.85, P < .0001; cutoff ≥ 3.5 vertebrae, Se 68%, Sp 86%) and VRHi (VD) (AUC 0.80, P = .0004; cutoff ≥ 3.0 vertebrae, Se 57%, Sp 95%). In conclusion, the lateral VRHi in LL and RL and the VD VRHi could represent useful radiological tools for the detection of RHE in dogs., (© 2024 American College of Veterinary Radiology.)

There are no published reports describing the anatomic variations of the phrenicoabdominal (PhAbd) veins in cats. The aim of this study was to evaluate the anatomic variations of the PhAbd veins in cats without adrenal disease. This is an anatomic study. Abdominal CT images of cats acquired from January 2021 to February 2023 were retrospectively reviewed. Inclusion criteria were the presence of pre- and postcontrast CT images of the abdomen and the absence of any abdominal diseases that compromise the left and right PhAbd veins visualization. A total of 128 cats were included. Three different vascular anatomic variations were found in the distal pericaval segment of the left phrenicoabdominal (LPhAbd) vein. In the first type, found in 65 cases (50.8%), the LPhAbd vein drained directly into the caudal vena cava. In the second type defined IIa, found in 25 cases (19.5%), the LPhAbd vein drained into the distal third of the left renal vein, less than 5 mm from its opening into the caudal vena cava. In the third type defined IIb, found in 38 cases (29.7%), the LPhAbd vein drained into the distal third of the left renal vein, more than 5 mm from its opening into the caudal vena cava. The right phrenicoabdominal vein had a consistent path and drained into the caudal vena cava in all cases. The knowledge of these vascular variations is expected to help the surgeon during adrenalectomy due to masses with vascular invasion in cats., (© 2024 American College of Veterinary Radiology.)

Susceptibility-weighted imaging (SWI) is a gradient echo (GE) MRI sequence. Intravenous administration of gadolinium (Gd) may affect GE images, but its effect on SWI has not been investigated in veterinary medicine. This cross-sectional prospective study evaluated the effects of Gd on SWI. Seventy-one dogs that underwent brain MRI were included and distributed in two groups. Susceptibility-weighted imaging was performed pre- and postcontrast, obtained immediately after Gd administration (Group A: n = 35) or delayed (Group B: n = 36; median delay 19.9 min). Pre- and post-Gd SWI were analyzed for signal intensity changes in the lentiform nuclei of gray matter (GM), in the centrum semiovale of white matter (WM), and in brain lesions. No difference in GM signal intensity was identified in either group between pre- and postcontrast images (Group A, P = .395; Group B, P = .895). In group A, WM signal intensity was lower in pre- than post-Gd sequences (P = .019). Brain lesions were identified in 30/71 (41%) cases; the signal intensity of intracranial lesions was significantly lower in pre- than post-Gd images in both groups (P < .001); the number of lesions influenced the difference in signal intensity in group B (P = .043). Susceptibility artifacts did not change in appearance between pre- and postcontrast images in either the normal brain or in parenchymal lesions. In conclusion, Gd may modify the signal intensity of WM and brain lesions but does not affect the susceptibility artifacts and does not interfere with SWI interpretation., (© 2024 American College of Veterinary Radiology.)

Introduction: The primary objective of this retrospective study was to document the normal variation of clinical mobility of the mandibular symphysis in cats and possible associations with bodyweight, age, sex, sexual status, breed and skull morphology. Secondarily, the radiographic appearance of the mandibular symphysis and possible associations with the analyzed data were evaluated., Materials and Methods: Two hundred and sixteen cats of 15 different breeds that underwent maxillofacial, oral and dental procedures from April 2015 to December 2021 were included. Clinical mobility was evaluated under general anesthesia using a 0 to 3 scale in lateromedial (LM) and dorsoventral (DV) directions. The symphysis was radiographically classified on the occlusal radiographic view of the rostral mandibles as fused or open, and with parallel or divergent margins., Results: Bodyweight ranged from 2.2 to 12.5 kg (median 4.0 kg), age from 4 months to 17 years and 4 months (median 6 years and 4 months). At the first evaluation DV symphyseal mobility was 0 in 177 cases (82%), 1 in 32 cases (14.8%) and 2 in 7 cases (3.2%), LM mobility was 0 in 61 cases (28.3%), 1 in 110 cases (50.9%) and 2 in 45 cases (20.8%). 81.1% of the radiographs were included in the statistical analysis. Three symphyses (1.6%) were classified as fused and 190 (98.4%) as open, 129 (68.8%) having divergent margins and 61 (31.6%) parallel. One hundred and forty-eight cases (76.7%) did not show the presence of odontoclastic replacement resorption on the canine teeth (TR subgroup 1), 23 (11.9%) showed stage ≤3 lesions (TR subgroup 2) and 22 (11.4%) stage 4 lesions (TR subgroup 3). Logistic regression models exploring factors that affected DV and LM mobility were statistically significant ( p  < 0.0001; p  < 0.0001) with an increase in LM mobility predicting an increase in DV mobility, and vice versa. An increase in DV mobility was associated with an increase in age and in having resorptive lesions. A decrease in LM symphyseal mobility was associated with being brachycephalic., Conclusion: The great majority of cases showed some degree of LM symphyseal mobility, and 18% showed DV mobility. Symphyseal bony fusion is rare but possible., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Minei, Auriemma, Bonacini, Kent and Gracis.)

Objective: This study aimed to determine psychosocial differences between children with Long-COVID Syndrome (LCS) and two control groups (i.e., children who did not have COVID-19 and children who had previously had COVID-19 but did not develop LCS) from a bio-psycho-social and psychosomatic perspective. To classify children in these three groups, we examined the percentage of children meeting criteria for LCS, the type, frequency, perceived severity of symptoms, and their prevalence compared with children who never had SARS-CoV-2 infection., Methods: Data were collected from 198 Italian mothers of children aged 4 to 13 years using a cross-sectional web-based case-control survey. Of these, 105 were mothers of children who had contracted SARS-CoV-2 and 94 were mothers of children who had previously had COVID-19. Information was collected on the type and frequency of symptoms commonly referred to as "Long-COVID symptoms" and psychosocial dimensions (i.e., maternal and child health anxiety, COVID-19 anxiety, adjustment, and child deprivation). Descriptive analyses, chi-square tests, Student's T-Test, and analyses of variance were performed., Results: 29 children (15% of the total sample) developed LCS, mostly in the neurological/neuropsychiatric domain (59%), and of mild intensity. Regarding psychosocial and psychological dimensions, maternal health anxiety, child deprivation, and fear of SARS-CoV-2 infection differed between groups, with the first two dimensions higher in children with LCS than in controls and the latter lower in children with LCS than in controls., Conclusion: This study sheds light on the need of integrating a psychosocial approach into the medical care of children with LCS and their caregivers., Competing Interests: Declaration of Competing Interest The authors have no competing interests to report., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: The primary objective of this retrospective study was to document the normal variation of clinical mobility of the mandibular symphysis in dogs, and evaluate possible associations with breed, bodyweight, age, sex, and skull morphology. Secondarily, the radiographic appearance of the mandibular symphysis and possible associations with the analyzed data were also evaluated., Methods: Medical records of dogs that underwent anesthetic procedures for maxillofacial, oral and dental evaluation from April 2015 to December 2021 were included., Results: 567 dogs of 95 different breeds were included, with a total of 695 evaluations. Body weight ranged from 0.8 kg to 79 kg (median 14.4 kg) and age from 3 months to 16 years and 4 months (median 6 years and 9 months). Clinical mobility was evaluated under general anesthesia using a 0 to 3 scale, in lateromedial (LM) and dorsoventral (DV) directions. The symphysis was radiographically classified as being fused or open. The open symphyses were further radiographically divided in having parallel or divergent margins. At the time of the first evaluation DV mobility was 0 in 551 cases (97.2%) and 1 in 16 cases (2.8%). LM mobility was 0 in 401 cases (70.7%), 1 in 148 cases (26.1%) and 2 in 18 cases (3.2%). There was not a significant change in mobility over time for cases examined more than once ( P = 0.76). All cases had an intraoral radiographic examination. 83.8% of the radiographs were included in the statistical analysis. Two symphyses (0.4%) were classified as fused and 473 (99.6%) as open, 355 (74.7%) having divergent margins and 118 (24.8%) parallel margins. Logistic regression models exploring factors that affected DV and LM mobility were statistically significant ( P < 0.0001; P < 0.0001), with an increase in LM mobility predicting an increase in DV mobility, and vice versa. An increase in age and in bodyweight was associated with a decrease in mobility. There was no statistical difference in clinical mobility across specific breeds or sexes. Increased probability of a divergent symphysis and increased DV mobility was found to be associated with a brachycephalic conformation. The increase in LM mobility was comparatively higher in small brachycephalic breeds compared with larger brachycephalic breed., Discussion: The majority of the cases showed little to no mobility of the mandibular symphysis and radiographically bony fusion can be rarely seen., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor FV declared a shared affiliation with the author MK at the time of review. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Minei, Auriemma, Bonacini, Kent and Gracis.)

Intestinal suture dehiscence is one of the most feared complications following gastrointestinal surgery in both human and veterinary medicine, increasing the morbidity and mortality of these patients. Clinical and laboratory early signs of septic peritonitis are not always easily identifiable while prompt treatment should help decrease postoperative morbidity and mortality. The aim of this study is to describe the ultrasonographic (US) features of confirmed leakage of intestinal sutures (LIS) and to evaluate if this imaging technique can be useful as noninvasive tool for the early diagnosis of LIS. Seven dogs developed LIS in a range of three-four days after gastrointestinal surgery and four of these developed a second dehiscence. On B-mode ultrasonography, all intestinal surgical sites were identified and characterized by a bowel focal thickening with reduced or absent wall layering and the presence of hyperechoic, double-walled foci at regular intervals (suture material). Furthermore, hyperechoic linear interfaces associated with dirty acoustic shadowing and comet-tail artifacts crossing the intestinal wall to free-float in peritoneal cavity or in a saccate collection have been documented. On the basis of these preliminary results, canine abdominal ultrasound seems to be a useful diagnostic technique for post-operative monitoring of patients undergoing intestinal surgery, allowing early detection of signs of a LIS, before the patient develops clinical signs of septic peritonitis., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Costanzo, Linta, Auriemma, Perfetti, Del Magno and Diana.)

When people receive a diagnosis of chronic or non-communicable disease, they need to reorganize their lives to understand and accommodate the changes associated with the new health condition. This reorganization, which involves the activation of a process through which meaning is given to the illness, could be fostered by narrative methods also in the context of Primary Care. The Sense of Grip on Disease (SoGoD) model intends to focus on the role of sense-meaning-making processes in the psychological adjustment to non-communicable illness, emphasizing the patients' role in managing their own health condition. In this study, the authors propose a mixed-method research method which implies the adaptation of the narrative interview on the Sense of Grip on Disease. The interview was administered to 31 adults suffering from non-communicable diseases and has been analyzed with a theory-driven approach, which aims to explore the modalities of five narrative functions: organization of temporality, integration of illness, expression of emotions, social sharing and orientation to action. Through a Multiple Correspondence Analysis and a Cluster Analysis, the authors have identified two different 'Grip Profiles', called "Dynamic Profile" and "Compliant Profile", representative of different degrees of flexibility, integration and adjustment to disease.

The COVID-19 pandemic produced several ethical challenges for nurses, impacting their mental health and moral distress. In the moral distress model the categories of events related to moral distress are: constraint, dilemma, uncertainty, conflict, and tension, each one related to different emotions. This study explored moral events' memories and emotions in narratives of a sample of 43 Italian nurses who worked during the COVID-19 pandemic. We constructed an ad-hoc narrative interview asking nurses to narrate the memory, and the associated emotion, of an event in which they felt they could not do the right thing for the patient. We conducted a theory-driven analysis, using the categories proposed by the literature, identifying the main emotion for each category. Results show that 36 memories of events are representative of moral distress; among these, 7 are representative of none of the categories considered, and we categorized them as moral compromise. The main emotional trajectories are powerlessness, worthlessness, anger, sadness, guilt, and helplessness. From a clinical psychological point of view, our findings highlight the narration of the memories of moral events as a tool to use in the ethical sense-making of critical experiences, in order to promote well-being and moral resilience among nurses in emergency situations.