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Timing of Treatment for Craniosynostosis and Faciocraniosynostosis: A 20-Year Experience
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
In patients who presented early with non-syndromic craniosynostosis or brachycephaly, treatment was undertaken according to the protocol outlined in Table 18.1. The authors reported that up to 2 years of age, there was little difference in the management of craniosynostosis except for patients with brachycephaly (Table 18.1). The change in protocol for patients with brachycephaly was due to the reduced potential for postoperative brain expansion after 6 months of age. They advised that between 2 and 5 years old the same surgical techniques can be utilised; however, the bone is more difficult to cut and mould, and breaks easily.
Ethical Considerations
Published in Rebecca A. Krimins, Learning from Disease in Pets, 2020
Presuming that a protocol passes the Replacement and Reduction tests, then it falls to Refinement to protect the animal from unnecessary harm. If the pet is already ill or injured per the objectives of the study, is the current standard of veterinary care for that condition described in the protocol? [NB: a “standard of care” may not actually be standardized and can vary between states, institutions, and even veterinarians (Block 2018); although the phrase may imply universality, an extensive description in the protocol may still be warranted.] Even if healthy rather than sick pets are desired, there may still be opportunities for Refinement to avoid or lessen the chances for unintended injury or mental distress. This holds especially true if those healthy pets are very old or very young, or if they have conformational traits that pose risks, such as brachycephalic animals prone to dyspnea from high ambient temperature and humidity, or animals with short or arthritic legs expected to climb high steps.
SBA Answers
Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
E HCThe threshold for CRL for estimating gestational age is 84 mm, as suggested by ISUOG. The BPD is less reliable in determining gestational age because of variations in skull shape, such as dolichocephaly or brachycephaly; hence, some authors feel that BPD is less reliable than HC. As a single parameter, HC correlates better to gestational age than the other three standard parameters in the second trimester, and as with all others, it becomes less accurate with increasing gestational age. It is more challenging to measure the fetal AC than the other parameters. The abdomen has no bright echoes of bone, it is not always symmetrical, and its size will vary with fetal respiration and central body flexion/extension. Of all the fetal biometric parameters, this measurement has the most variability as it is somewhat dependent on fetal growth factors and body position. (Determination of Gestational Age by Ultrasound. SOGC Clinical Practice Guideline No. 303, February 2014)
Naturally Occurring Canine Glioma as a Model for Novel Therapeutics
Published in Cancer Investigation, 2018
Molly E. Hubbard, Susan Arnold, Abdullah Bin Zahid, Matthew McPheeters, M. Gerard O’Sullivan, Alexandru-Flaviu Tabaran, Matthew A. Hunt, G. Elizabeth Pluhar
A total of 99 surgeries were performed on 95 pet dogs, 39 female and 56 male; four dogs underwent two surgical interventions. Eight dogs were excluded from analyses as the final pathology was not glioma. The age ranged from 0.75 to 14.04 with a mean age of 8.3 years. There was an increased incidence in certain brachycephalic breeds, specifically Boxer, Boston, and Staffordshire terriers and French and English bulldogs. Demographic and histologic data are described in Table 1. Seizure was the most common presenting symptom, being present in 83 (87%) dogs at the time of presentation for surgery. Followup rate till death was 100%, however, not all animals had necropsy.