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The management of unruptured intracranial aneurysms requires knowledge of the natural history of these lesions and the risks of repairing them.A total of 2621 patients at 53 participating centers in the United States, Canada, and Europe were enrolled in the study, which had retrospective and prospective components. In the retrospective component, we assessed the natural history of unruptured intracranial aneurysms in 1449 patients with 1937 unruptured intracranial aneurysms; 727 of the patients had no history of subarachnoid hemorrhage from a different aneurysm (group 1), and 722 had a history of subarachnoid hemorrhage from a different aneurysm that had been repaired successfully (group 2). In the prospective component, we assessed treatment-related morbidity and mortality in 1172 patients with newly diagnosed unruptured intracranial aneurysms.In group 1, the cumulative rate of rupture of aneurysms that were less than 10 mm in diameter at diagnosis was less than 0.05 percent per year, and in group 2, the rate was approximately 11 times as high (0.5 percent per year). The rupture rate of aneurysms that were 10 mm or more in diameter was less than 1 percent per year in both groups, but in group 1, the rate was 6 percent the first year for giant aneurysms (or =25 mm in diameter). The size and location of the aneurysm were independent predictors of rupture. The overall rate of surgery-related morbidity and mortality was 17.5 percent in group 1 and 13.6 percent in group 2 at 30 days and was 15.7 percent and 13.1 percent, respectively, at 1 year. Age independently predicted surgical outcome.The likelihood of rupture of unruptured intracranial aneurysms that were less than 10 mm in diameter was exceedingly low among patients in group 1 and was substantially higher among those in group 2. The risk of morbidity and mortality related to surgery greatly exceeded the 7.5-year risk of rupture among patients in group 1 with unruptured intracranial aneurysms smaller than 10 mm in diameter.

BackgroundUltrasonography (US) is the recommended imaging technique to evaluate jugular veins. This prospective randomized clinical study was designed to collect a series of B-mode US measurements of manually distended jugular veins in healthy Italian Standardbreds and to find possible correlations between ultrasound measurements and animal morphometric characteristics. Forty-two horses, eight males and 34 females (range 3–22 years; bodyweight 494.4 ± 41.7 kg), were included in the study. The diameters and wall thicknesses of both jugular veins were measured at three different sites of the neck. The differences in ultrasound measurements based on scans, age, gender, side, and site of the neck were evaluated by ANOVA or by the Kruskal-Wallis test. The effects of the morphometric measures on each ultrasound parameter were evaluated by MANOVA (P ResultsThe ultrasound measurements did not differ significantly between the three different sites or between genders; hence, they were pooled together in the results. On the transverse scan, the mean dorsoventral and lateromedial diameters were 1.58 ± 0.23 and 2.20 ± 0.25 cm, respectively; the mean superficial and deep wall thicknesses (SWT and DWT) were 0.07 ± 0.01 and 0.08 ± 0.01 cm, respectively. On the longitudinal scan, the mean dorsoventral diameter was 1.59 ± 0.26 cm, and the SWT and DWT were both 0.08 ± 0.01 cm. Neck length, from the caudal edge of the mandible to the thoracic inlet, was related to the dorsoventral diameter in both longitudinal and transverse scan and to the SWT and DWT in transverse scan, whereas height at the withers (measured with tape) and estimated weight were related to the wall thickness. Dividing the subjects into groups by age in years (“young” 3–7, “mature” 8–14, “old” > 14), differences were found for the lateromedial diameter in the transverse scan and the SWT on the longitudinal scan. The main limitation of this study was that only one operator performed the measurements.ConclusionThe US measurements of the jugular veins and their relationship with morphometric measures reported in this manuscript might be considered as guidelines both for early diagnosis and monitoring jugular vein abnormalities in healthy Italian Standardbred horses.

Recurrent respiratory infections (RRIs) are a common clinical condition in children, in fact about 25% of children under 1 year and 6% of children during the first 6 years of life have RRIs. In most cases, infections occur with mild clinical manifestations and the frequency of episodes tends to decrease over time with a complete resolution by 12 years of age. However, RRIs significantly reduce child and family quality of life and lead to significant medical and social costs. Despite the importance of this condition, there is currently no agreed definition of the term RRIs in the literature, especially concerning the frequency and type of infectious episodes to be considered. The aim of this consensus document is to propose an updated definition and provide recommendations with the intent of guiding the physician in the complex process of diagnosis, management and prevention of RRIs. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-021-01150-0.

Thermography is a non-invasive diagnostic method commonly used to monitor changes of the body surface temperature potentially induced by different conditions such as fever, inflammation, trauma, or changes of tissue perfusion. Capacitive-resistive diathermy therapy (such as energy transfer capacitive and resistive&mdash, Tecar) is commonly used in rehabilitation due to its diathemic effect secondary to blood circulation increase that could accelerate the healing process. The aim of this study was to monitor by thermal camera the diathermic effects induced by Tecar on the surface of the region of application. The investigation was conducted on six dogs referred for Tecar therapy to treat muscle contractures (three dogs) or osteoarthritis (three dogs). Eleven anatomical treated regions were recorded. Thermographic images and relative measurements were obtained by each region immediately before (T0), at conclusion (T1), and sixty seconds after the Tecar application (T2). Data were recorded and statistically analyzed. A comparison of temperature differences (maximum, minimum and mean values) between T0 and T1, T0 and T2, and T1 and T2 was performed by ANOVA test with Bonferroni post hoc (p &le, 0.05). Statistically significant differences were detected for mean temperature between T0 (32.42 &plusmn, 1.57 &deg, C) and T1 (33.36 &plusmn, 1.17 &deg, C) (p = 0.040) and between T1 and T2 (32.83 &plusmn, 1.31 &deg, C) (p = 0.031). Furthermore, there was no significant difference between the mean temperature at T0 and T2, demonstrating that superficial diathermic effect exhausted within 60 s.

Simple Summary Competitions dedicated to working dogs have greatly expanded in order to select the best canine individuals for Search-and-Rescue (SAR) activity. Therefore, it is essential to identify physiological parameters for a rapid clinical evaluation in order to provide useful information on the physical fitness of athlete dogs. In the present study, heart rate, respiratory rate and rectal temperature were investigated during three different working activities. Heart rate was the most conditioned parameter by exercise and, probably, the most useful to evaluate the canine predisposition and response to work. Respiratory rate and rectal temperature were more affected by environmental variables. Abstract Physiological changes (pulse rate, respiratory rate and rectal temperature) induced by exercise are usually studied as physical fitness indices. The aim of this study was to investigate how these physiological parameters could be modified in a group of trained working dogs during three different field trials (rubble, search on field, obedience), in order to assess which parameter would be more useful to detect the dog response to exercise. Nine dogs were included in this study. The animals were monitored at rest, immediately before and after the working session. Pulse rate values increased significantly in all the phases compared to rest status. Respiratory rate values increased significantly after the competition, while rectal temperature was significantly increased only after search on rubbles and obedience activities. Reference values for specific competitions need to be stablished in order to promptly identify poor performance or exercise intolerance.

Cranial cruciate ligament (CrCL) rupture is one of the most common orthopaedic conditions in veterinary medicine. CrCL plays a fundamental role in the stability and biomechanics of the femoral-tibio-patellar joint, and its incorrect functionality severely impacts on the quality of life of patients. In dogs, the structural weakening of this joint due to the progressive degeneration of the ligament is the most accredited etiopathogenetic hypothesis in relation to the dog signalment (breed, sex and age) and the stifle joint conformation. In humans, this injury is often traumatic and generally occurs during sporting activities. CrCL rupture can be managed conservatively or surgically, and decisions regarding treatment are due to numerous factors: the patient’s age and health, the degree of stifle instability, and cost. Physiotherapy protocols play an important role in rehabilitation, with similar goals in humans and dogs: pain management, physiological articular range of motion recovery, periarticular and core muscle strengthening, and proprioceptive deficit correction. Physiotherapy, even if often neglected in veterinary medicine, is mandatory for the recovery of the correct functionality of the injured limb and for the return to normal daily and sporting activities.

Bio-methane as fuel in a natural gas engine is a viable solution to reduce greenhouse gas emissions. The present paper illustrates the results of the first set of measurements carried out in the BiomethER project (EULIFE). BiomethER aimed to design and build two innovative bio-methane production plants, located in Emilia Romagna region (Italy), fed by different feedstock: the first one with sewage sludge and the other with landfill waste. Biogas extracted by the anaerobic digester was cleaned and upgraded to biomethane for road vehicles application. To verify the compatibility of biomethane in conventional compressed natural gas engine (CNG) vehicles, three passenger cars have been tested with two gases: conventional natural gas and bio-methane coming by BiomethER sewage sludge plant. Test concerned dynamic performances and exhaust emissions and was operated on the chassis dynamometer facility, in ENEA Casaccia Research Centre. Preliminary results showed no appreciable deviation was noticeable for fuel consumption and CO2 emissions between the two fuels, acceleration and maximum power were almost the same for the three vehicles tested. The WTW evaluation of GHG emissions for the biomethane resulted in up to 79% lower in comparison with natural gas provided by the Italian pipeline.

This preliminary study was designed to contribute to the evaluation of reliability of plasma lactate concentration (PLC) and its clearance as predictive and prognostic factors of gastric necrosis and clinical outcome of dogs affected by gastric dilatation-volvulus (GDV). Main aims of the study were: 1) to evaluate the prognostic reliability of PLC at presentation (T0) in dogs with GDV, 2) to compare the obtained data and considerations with the veterinary literature, and 3) to introduce the possible validity of PLC values at 24 (T24) and 48 (T48) hours after surgery as a predictive factor. Dogs with GDV were retrospectively evaluated. PLC at T0, T24 and T48 were recorded and correlated to the presence or absence of macroscopic necrosis of the stomach and to outcome. Forty-five dogs met the inclusion criteria. Significant differences were not detected in the mean values between the initial PLC in dogs with and without necrosis of the gastric wall, as well as between surviving and non-surviving dogs; these values were not associated with higher risk of gastric necrosis or death. At T24 and T48 no significant differences were recorded between necrosis and non-necrosis, and surviving and non-surviving categories. A median plasma lactate concentration clearance from arrival to T24 ≥ 50% was identified in both groups (with and without necrosis), and this parameter failed in identifying dogs that survived to discharge. In conclusion, the results presented here failed to detect PLC at T0 and its clearance at T24 as prognostic factors in this population of dogs with GDV., Surgery; Veterinary Medicine; Health Sciences; Surgery; Abdominal Surgery; Emergency Medicine; Plasma lactate concentration; Prognostic factor; Gastric dilatation-volvulus; dog; Gastric necrosis

Forelimb lameness in medium and large breed dogs is frequently caused by traumatic or degenerative injuries of the shoulder. Patient history, physical examination, x-rays, blood, and chemical work are routinely used to achieve diagnosis, and may be associated with ultrasonography or magnetic resonance imaging. Ultrasonography is increasingly popular in small animal practice due to its low cost, ease of repetition, and the fact that it is non-invasive and can be performed in conscious patients. It is also widely accepted that muscular stress or injuries can induce detectable variations in blood and chemical work. The aim of this preliminary study is to search for correlation between measurements of selected hematobiochemical parameters and ultrasound diagnosis in dogs affected by shoulder injuries. A retrospective study was conducted on orthopedic clinical records of dogs presented to our Veterinary Teaching Hospital for lameness caused by shoulder problems over a period of 5 years. Dogs with both hematobiochemical and ultrasound examinations were selected. Patients were classified into 5 groups according to ultrasound diagnosis: (1) mild/moderate tendinopathy, (2) severe tendinopathy, (3) articular damage, (4) chronic myopathy, and (5) neoplastic injury. Statistical analysis was performed to detect possible correlations between group and hematobiochemical parameters. Forty-four dogs met the inclusion criteria and forty-nine shoulders were diagnosed as injured. Significant differences were found between the age, sex, body weight, neutrophil count, and AST levels. In particular, statistically significant increases were found for neutrophil count and AST concentration in case of ultrasonographically diagnosed severe tendinopathy, articular damage, and neoplastic pathology. Further and wider studies are suggested to determine whether these biomarkers can become a useful diagnostic aid.

The objective of this retrospective study is to describe a surgical technique to correct large, recurrent, incisional hernias in horses using a polypropylene mesh. The study sample included 15 horses with large hernias (range, 16−43 cm in length) developed after failure of previous abdominal closure. A double-layer polypropylene mesh was inserted between the internal rectus abdominis muscle sheath and peritoneum. Wound healing was assessed using clinical and ultrasonographic examinations. During a follow-up period of 6 months, no major complications related to the surgical procedure were observed. Subfascial retroperitoneal insertion of a double-layer polypropylene mesh is a valuable treatment option in cases of large and complicated incisional hernias in horses.

Mammary gland neoplasms in mares are rare. This report describes the clinical and histopathological findings in a mare with mammary gland adenoma, discussing the results of immunohistochemistry undertaken to determine the expressione of hormone receptors.

The aims of this research were to evaluate mean echogenicity (ME) of the deep and superficial digital flexor tendons (DDFT and SDFT), the interosseous muscle (IM), and the accessory ligament of the deep digital flexor tendon (ALDDFT) of the metacarpal region in neonatal foals, and determine the effect of sex, side and body weight on this quantitative ultrasonographic evaluation. Thirteen orthopedically sound neonatal foals were examined. Four areas of study (1A, 1B, 2A, 2B) were identified. Transverse scans of the DDFT, SDFT, IM and ALDDFT were obtained, recorded, and analyzed. The most echogenic structures were the ALDDFT and DDFT, while the SDFTwas significantly less echogenic than all other structures (P b 0.05). No influence of sex, forelimb, or body weight was observed. The echogenicity of the tenodesmic structures of foals partially overlapped that reported in the metacarpal region in adult horses, except for IM.

We present a case of zoster sine herpete causing isolated acute dysphagia in an immunocompetent patient. The interest of this paper is the atypical presentation of varicella-zoster virus reactivation. A 77-year-old woman presented with a 3-day history of fever and worsening dysphagia for both liquid and solid foods. Cerebrospinal fluid examination revealed lymphocytic pleocytosis and PCR amplified varicella-zoster virus DNA with high antibody titers in both serum and cerebrospinal fluid. The panel was suggestive of a cranial neuritis due to varicella-zoster virus, involved cranial nerves, even in the absence of a cutaneous and mucosal rash. Varicella-zoster virus reactivation should be included in the differential diagnosis of isolated or multiple cranial nerve palsies, with or without zosteriform skin lesions. A prompt etiologic diagnosis can lead to early administration of antiviral therapy. © 2014 Elsevier B.V.

Objective of this study was to describe intraocular measurements in newly born foals (1–7 days of age) and assess the association between globe measurements and gender, laterality, and body weight. B-scan ultrasonographic biometry was performed on both eyes of 22 healthy foals (44 eyes) ages 1–7 days using a 10-MHz transducer. Intraocular measurements (anterior chamber depth, central lens thickness, vitreous chamber depth, axial globe length, longitudinal globe length, lens poles distance) were carried out using the ultrasound internal calipers. The influence of gender (male or female), laterality (right or left eye), and body weight (‘‘light’’ ,48 kg; ‘‘heavy’’ $48 kg) on ocular measurements was analysed by the Student t test. Values of P,0.05 were accepted as significant for all analyses. Mean anterior chamber depth was 2.260.5 mm (Standard Deviation); central lens thickness was 9.960.8 mm; vitreous chamber depth was 15.561.1 mm; axial globe length was 27.661.6 mm; longitudinal globe length was 35.861.2 mm, and lens poles distance was 16.461.0 mm. Intraocular measurements were not influenced by gender, laterality nor body weight. This study provides reference values for intraocular measurements in neonatal foals and may be useful in the diagnosis and treatment of congenital and acquired pathologies involving the globe.

An 8-year-old Italian saddle-horse gelding with a history of left guttural pouch empyema was referred to the clinic. Endoscopic examination showed a stenosis of the left pharingeal ostium that was treated with an endoscopic assisted electro-cauterization. Endoscopic follow-ups were performed before discharge and at six months after stenosis removal. No recurrence was observed, confirming the patency of the pharyngeal orifice.

The growing number of sales channels through which customers can make purchases has made it imperative for managers to understand how customers decide which channels to use. However, this presents a significant challenge because there is reason to believe the channel decision process evolves over the lifetime of the customer. The authors document the existence and nature of this phenomenon by analyzing the evolution of a customer's channel choice decision process from a trial stage to a posttrial stage. First, they analyze data for a book retailer and replicate their analysis using data from a durables and apparel retailer. Their results suggest that (1) customers’ decision processes do evolve, (2) a minority but sizeable segment changes decision processes within the observation period, and (3) customers who change do so from a decision process in which they are highly responsive to marketing to one in which they are less responsive. The authors illustrate and discuss the implications for both managers and researchers.

Lung lobe torsion (LLT) is an uncommon pathology in small animal practice. In large breed dogs LLT effects are localized mainly to the middle lobe of the right lung. This report describes a case of left cranial lung torsion in a Bernese Mountain dog: the patient was referred with a two-day history of asthenia, anorexia, dyspnea and haemoptysis. No trauma was reported. Physical examination showed the presence of bilateral pleural effusion confirmed by radiography and ultrasonography. Broncoscopy revealed that the left cranial lobe appeared to be compressed laterally with complete occlusion of the lumen. Thoracoscopy was performed to exclude other patholo - gies of the pleural space. The pathological lobe was removed. Histological examination revealed aspects consistent with lung lobe torsion. Clinical follow up carried out after three months showed a normal clinical course.

Objective— To report sartorius muscle contracture in a dog. Study Design— Case report. Animals— A 5-year-old, male, German Shepherd dog. Methods— After a 2-month history of right hindlimb lameness was treated by tenectomy of the caudal sartorius muscle for sartorius muscle contracture. Results— One month after surgery there was complete remission of clinical signs; however, after 12 months, there was partial reunion of sartorius caudal belly and onset of gracilis muscle contracture. Conclusions— Contracture of the sartorius muscle in dogs is seemingly rare and similar to gracilis muscle contracture with which it may be confused. Differentiation requires knowledge of muscular anatomy, careful palpation, and surgical inspection. Clinical Relevance— Sartorius muscle contracture can be treated by tenectomy or removal of contracted muscle tissue, however, long-term outcome suggests the need to develop approaches that prevent recurrence caused by scarring of transected tissues.

The horse tarsus is a particularly complex region and its echographic evaluation can involve several diagnostic doubts. The necessity to define a procedural protocol, similar to those accepted for the metacarpal and metatarsal regions (Genovese et al., 1986), has already been recognized (Denoix and Crevier, 1991; Dik, 1993) but it has not yet led to the creation of standard protocols. The authors propose subdivision of the tarsal region to facilitate correct and systematic investigation of some specific structures in this region.