Cocaine consumption has increased over the last decade. The potent sympathomimetic effects of the drug can lead to serious neurovascular complications in the form of ischemic stroke (IS), intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH). This systematic review and meta-analysis were designed to describe the clinical features and outcomes of patients suffering from IS, ICH, or SAH occurring in the context of cocaine use. The PubMed, Embase, Cochrane, and Web of Science libraries were queried in December 2022. Studies were included if they provided information regarding the epidemiology, clinical presentation, or outcomes in cocaine-associated strokes. Odds ratios (OR) were pooled using a random-effects model. A total of 36 papers were included. Strokes associated with cocaine use were more prevalent in younger populations and those of African American descent. Cocaine use increased the odds of IS, ICH, or SAH (OR = 5.05, p < 0.001). The odds of mortality (OR = 1.77, p = 0.0021), vasospasm (OR = 2.25, p = 0.0037), and seizures (OR = 1.61, p < 0.001) were also worse when strokes were associated with cocaine use. In addition to counseling patients on the benefits of drug cessation, clinicians should remain vigilant of the potential complications in patients who are hospitalized with cocaine-associated strokes.

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Patellar dislocation is one of the main osteoarticular diseases described in the surgical routine of pet animals, the treatment of which differs according to the degree of dislocation based on the clinical changes presented by each patient. The present report aims to describe the association of the femoral corrective osteotomy technique, total trochlear replacement of the knee by prosthetics, and tibial tuberosity transposition with a tool for correction of grade IV patellar dislocation in a 1.5-year-old German Spitz dog with femoral varus deviation and external tibial torsion. The treatment allowed the correction of femoral bone deformation, realignment of the quadriceps extensor mechanism, and permanent maintenance of the patella on the prosthetic trochlear sulcus with early functional return of the limb, absence of pain, and lameness.

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Medial patella luxation is a condition resulting from congenital bone deformities that in the long term may result in rupture of the cranial cruciate ligament. These orthopedic ailments are responsible for much of the pelvic limb claudication in dogs and degenerative joint disease. Claudication and joint pain are the main clinical manifestations, and the diagnosis is confirmed by orthopedic examination for both conditions. The simultaneous treatment of these diseases is a challenge for the surgeon. This study reports on the association of trochlear sulcus replacement with prosthesis with modified plateau leveling osteotomy for simultaneous treatment of grade III medial patellar dislocation and cranial cruciate ligament rupture in dogs.

No abstract

The concern about pain management in exotic mammals is increasing. However, only a few studies describe locoregional anesthesia techniques in rabbits. Thus, this report aims to describe the lumbar paravertebral block, guided by peripheral nerve stimulation, in a rabbit undergoing mid-femoral amputation. We received a one-year-old rabbit weighing 1.27kg with a history of non-union of the right femur and osteomyelitis. The animal came to us for high pelvic limb amputation. After premedication with ketamine, midazolam, and morphine, the patient was maintained under general anesthesia in a non-rebreathing circuit under spontaneous ventilation with isoflurane vaporized in 0.6 oxygen. Using a peripheral nerve stimulator, we performed the lumbar paravertebral block, positioning the needle between the L5 and L6 vertebrae and injecting 0.2mL/kg bupivacaine. The patient remained stable throughout the procedure, without the need for analgesic rescue with opioids during surgery and postoperatively. The discharge occurred after 24 hours. The lumbar paravertebral block proved efficient for trans and postoperative analgesia for high pelvic limbic amputation in rabbits.