No abstract
The use of renal biopsy through laparoscopy is increasingly present both in human and veterinary medicine. However, both techniques require skill and training to make the operator capable to do it. The learning curve allows the quantitative and qualitative assessment of the number of attempts and minimum time for the surgical procedure. The objective included establish the learning curve for laparoscopy-guided kidney biopsy procedures in dog and pig corpses. Six dogs and six pigs corpses weighing less than 10 kg were used for this study. All corpses underwent kidney biopsy performed through laparoscopy. Twenty-four operators, two per animal, performed 20 renal biopsies each (10 for each kidney), with 480 collection-procedures in total. Duration and difficulty of the procedure and the biopsy sample quality were evaluated and statistical analysis was performed using a mixed regression model with a random effect of individuals and multivariate analysis of data. There were 91.5% of the samples that were adequate for evaluation. There was no significant difference in the number of glomeruli or cortex percentage considering the attempts in either species, demonstrating the operator’s ability since first collection. Swine samples showed higher amounts of renal cortex than canine samples. The procedure duration was shorter as more attempts were performed in dogs and pigs. From the fourth repetition, the professional reached a plateau for the variable related to ‘collection’, and from the second, the professional presented uniform duration for ‘sample storage’. Operators of the swine model acquired more agility than the dog ones. The variable ‘difficulty’ decreased as more repetitions were performed, reaching a plateau in the sixth attempt. Seven renal biopsies laparoscopy-guided are required for an operator to be considered ‘capable’ to perform the procedure in the referred species included. The learning curve for image-guided kidney biopsy procedures improves the implementation of this technique and benefits patients that undergo this procedure.
The purpose of this study was to evaluate and compare positive cystography techniques at 5%, 10%, and 20%, as well as three different double-contrast protocols for detecting radiolucent uroliths with a diameter of less than 3.0 mm in dogs. Six cadavers were used, one was selected at random to represent the negative control, and the others were submitted to urolith implantation in the bladder by urethral catheter. Three radiology professionals blindly accessed ventrodorsal and -lateral projections of each test. Contrast at 20% showed greater diagnostic sensitivity, but with greater difficulty identifying the number and size of the uroliths. Consequently, double-contrast techniques are better and should be used for diagnostic and therapeutic planning. Sensitivity and specificity tests demonstrated that positive 5% cystography and different concentrations of double contrast obtained better results in terms of sensitivity and specificity. However, due to the presence of a greater amount of artifacts in the 5% cystography, it is suggested that double contrast is used for this purpose, especially with the removal of contrast excess (protocol 2).
Lupus erythematosus complex is an immune-mediated dermatological disease, mainly represented by the generalized and discoid forms. The last form described is milder, as it is limited to the appearance of lesions, usually on the face and in mucocutaneous regions. Its pathophysiology is considered multifactorial, however, continuous exposure to ultraviolet radiation seems to be very relevant to trigger and/or worsen clinical manifestations. DeÞ nitive diagnosis is obtained by histopathological analysis, and treatment is mainly based on immunosuppression and protection against ultraviolet radiation. The objective of this study was to report the case and clinical evolution of a mixed breed bitch, diagnosed with discoid lupus erythematosus. The bitch presented moderate desquamation, crusts and depigmentation restricted to the nasal plane. No other clinical or laboratory Þ ndings were evidenced in the screening tests. Upon conÞ rmation by histopathology, the initial therapy was started with oral prednisolone. The owners were also instructed to avoid exposure to sunlight, as well as to use topical protectors against ultraviolet radiation. The patient presented good response to therapy, showing remission of signs. Other sporadic recurrences were observed later, however, they were controlled only with topical corticosteroids, but always reinforcing the other precautions of environmental management. This work also addressed the risks, beneÞ ts and need to institute ongoing care to control discoid lupus erythematosus. Therapeutic success can vary among patients, as the intensity of the disease can be manifested in varying degrees. Therefore, in those individuals in which the condition is mild, it may be advantageous to opt for more conservative therapies in order to avoid side effects.
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