OBJECTIVE To assess the relationship between preoperative volume of primary intracranial gliomas in dogs as determined via MRI and survival time after surgical debulking and adjunctive immunotherapy. DESIGN Retrospective cohort study. ANIMALS 47 client-owned dogs enrolled in clinical trials regarding glioma treatments. PROCEDURES Medical records of all dogs undergoing craniotomy at the University of Minnesota Veterinary Medicine Center with histologically confirmed glioma between 2008 and 2015 were retrospectively reviewed, and outcome data were collected. Preoperative T2-weighted or post-gadolinium administration T1-weighted MRI scans, performed at several referral institutions with scanners of magnet strengths ranging from 0.5 to 3.0 T, were used to measure tumor volumes as a percentage of total calvarial volume. Data were analyzed to assess the effect of each 2% fraction of tumor volume on median survival time (MST) after surgery and adjuvant treatment. RESULTS Tumor volumes ranged from 0.5% to 12.2% of total intracranial volume. Overall MST was 185 days (range, 2 to 802 days). No association was identified between preoperative tumor volume and MST. Only 3 (6%) dogs had low-grade tumors that had relatively small volumes, measuring 1.4%, 2.1%, and 4.3% of total calvarial volume. The MST for these 3 dogs (727 days) was longer than that for high-grade tumors (174 days); however, owing to the low number of dogs with low-grade tumors, no statistical comparison was performed. CONCLUSIONS AND CLINICAL RELEVANCE Preoperative tumor volume determined via MRI was neither associated with nor predictive of outcome following surgery and adjunctive treatment for dogs with glioma. Tumor grade was predictive of outcome, but unlike tumor volume that was measured with MRI, invasive biopsy was necessary to definitively diagnose tumor grade.
OBJECTIVE To evaluate erythema and number of CFUs on the skin of dogs with hair clipped by use of 2 sizes of clipper blades. ANIMALS 67 client-owned dogs receiving an epidural. PROCEDURES Hair was clipped with a No. 10 blade (approx hair length, 1.5 mm) on one half and a No. 40 blade (approx hair length, 0.25 mm) on the other half of each epidural site. Skin was surgically scrubbed with 2% chlorhexidine gluconate and 70% isopropyl alcohol. Samples were obtained immediately after clipping, after skin was scrubbed, and again 24 hours after clipping. Number of CFUs for both sides of the clipped areas, types of microorganisms, and growth on MacConkey agar were evaluated every 24 hours for 72 hours. Colonies were evaluated for bacterial morphology and Gram stain characteristics. Sites were evaluated 24 hours after clipping for evidence of erythema. RESULTS 24 hours after hair was clipped, there was a significantly higher incidence of erythema and higher number of Micrococcaceae bacteria for the side clipped with the No. 40 blade than the side clipped with the No. 10 blade. Number of CFUs did not differ significantly between size of clipper blades. CONCLUSIONS AND CLINICAL RELEVANCE Clipping hair with a No. 40 blade resulted in a significant increase in the incidence of erythema and higher number of Micrococcaceae bacteria, compared with results for clipping with a No. 10 blade. These results supported use of a No. 10 clipper blade to prevent erythema and reduce variation in the skin microbiome.
Patients receiving tangential breast irradiation represent a significant proportion of the workload in a radiotherapy department. This paper describes the optimisation of an existing technique for tangential breast irradiation. Simulator sessions have been made more efficient by adopting a systematic approach to the simulation process, and set up times on treatment have been reduced and accuracy increased by improving the reliability of the patient set-up. There has been an overall reduction in both the problems and the time taken to both simulate and treat patients.Patient position variation has been minimised by the use of vac-fix bags and the choice of reference tattoo placement on the patient's skin. The single simulation session for planning treatment has been organised into three parts: definition of target volume, calculation of treatment and field parameters and simulation of treatment fields. The improvement in patient set-up on treatment has been confirmed by a reduction in the variability of FSDs measured during treatment.
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