OBJECTIVE To evaluate the outcome for cats with benign ureteral obstructions treated by means of ureteral stenting and to compare the outcome for these cats with outcome for a historical cohort of cats treated by means of ureterotomy only. DESIGN Prospective study with historical cohort. ANIMALS 62 client-owned cats with benign ureteral obstructions, including 26 cats treated with ureteral stenting and 36 cats previously treated with ureterotomy. PROCEDURES Data were recorded prospectively (ureteral stent cases) or collected retrospectively from the medical records (ureterotomy cases), and results were compared. RESULTS Cats treated with ureteral stents had significantly greater decreases in BUN and serum creatinine concentrations 1 day after surgery and at hospital discharge, compared with values for cats that underwent ureterotomy. Six cats in the ureteral stent group developed abdominal effusion after surgery, and cats in this group were significantly more likely to develop abdominal effusion when a ureterotomy was performed than when it was not. Cats that developed abdominal effusion after surgery were significantly less likely to survive to hospital discharge. Cats that underwent ureteral stenting were significantly more likely to have resolution of azotemia prior to hospital discharge than were cats that underwent ureterotomy alone. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that cats with benign ureteral obstructions treated with ureteral stenting were more likely to have resolution of azotemia prior to hospital discharge, compared with cats undergoing ureterotomy alone. Results of ureteral stenting were encouraging, but further investigation is warranted.
Minimally invasive OVE is an acceptable operative approach to those in the veterinary community. Additional study is required to correlate these findings with the general veterinary client population.
Background: In myocardial infarction with non-obstructive coronary arteries (MINOCA), there are limited patient-level data on outcomes by sex and race. Objective: Assess baseline demographics and 3-year outcomes by sex and race for MINOCA patients. Methods: Patients admitted to a single center with acute myocardial infarction (AMI) between January 1, 2012 and December 31, 2018, were identified by chart and angiographic review. The primary outcome was nonfatal MI with secondary outcomes including non-fatal cerebrovascular accident (CVA), chest pain readmission, and repeat coronary angiography. Results: During the study period, 304 patients were admitted with MINOCA. The cohort was predominantly female (66.4%), and women were significantly older (64.6 vs. 59.2). One-sixth of the total population were Black patients, and nearly half of Black patients (47.2%) were male. Prior CVA (19.7%) and comorbid anxiety, depression, or post-traumatic stress disorder (41.1%) were common. Rates of non-fatal myocardial infarction (MI) were 6.3% without difference by sex or race. For secondary outcomes, rates of CVA were 1.7%, chest pain readmission were 22.4%, and repeat angiography were 8.9%. Men were significantly more likely to have repeat angiography (13.7% vs. 6.4%), and Black patients more likely to be readmitted for angina (34.0% vs. 19.1%). Over one-quarter of patients underwent repeat stress testing, with 8.9% ultimately undergoing repeat angiograms and low numbers (0.7%) undergoing revascularization. Men were more likely to be referred for a repeat angiogram (13.7% vs. 6.4%, p=0.035). In multivariate analysis, Black race (OR 2.31 [95% CI (1.06-5.03)] was associated with an increased risk of readmission for angina, while female sex was associated with decreased odds of repeat angiography (OR 0.36 [95% CI (0.14-0.90)] and current smoking was associated with increased odds of repeat angiography (OR 4.07 [95% CI (1.02-16.29)] along with hyperlipidemia (OR 4.65 [95% CI (1.22-17.7)]. Conclusion: White women presented more frequently with MINOCA than White men, however Black men are equally as affected as Black women. Rates of non-fatal MI were low without statistical difference by sex or race.
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