Survival of Dairy Cows After Surgery to Correct Abomasal Displacement: 1. Clinical and Laboratory Parameters and Overall Survival

The objective of this study was to compare the clinical and laboratory consequences of left and right displacement of the abomasum (LDA and RDA), short‐ and long‐term survival after surgery and the findings in cows, that could not be cured by omentopexy. Data from 564 cases of displaced abomasum (466 LDA, 98 RDA) were analysed retrospectively. Clinical and laboratory findings were compared between the two manifestations of DA. Survival was assessed after 10 days and after 15 months. Necropsy was carried out on cows that died or were killed. On arrival at the clinic, left displacement of the abomasum (LDA) cows had been recognized as diseased for longer. LDA occurred earlier in lactation, and more cows with right displacement of the abomasum (RDA) were pregnant. Overall clinical symptoms were more severe in RDA than in LDA cows. Heart rate was higher, body temperature was lower, inanition, abnormal faeces and ruminal stasis were more frequent in RDA cows. Leucocyte counts were higher, and potassium and chloride levels were lower in RDA cows. Acetonuria was more frequent in LDA cows. More LDA than RDA cows were released from the clinic as cured (82.0% versus 74.5%). However, survival after the early post‐surgical period was similar for RDA and LDA cows. At necropsy, diseases of the gastrointestinal system were the predominant finding in RDA cows, while in LDA cows, diseases of the liver and other concurrent diseases were more important.     

Questionnaire analysis of the swallowing‐related outcomes following total laryngectomy

Objective: To determine the effects of a total laryngectomy on the swallow and subsequent quality of life in head and neck cancer patients. Design: Cross‐sectional single centre cohort study. Setting: Head and Neck Oncology Unit, Tertiary Referral Unit. Patients: Sixty‐two patients who underwent total laryngectomy at our centre participated in the study. Methods: Subjects were stratified by age, sex, tumour stage, other procedures such as myotomy and nerve re‐implantation. Pharyngectomy, glossectomy, flap reconstruction, neck dissection and previous radio‐ and chemotherapy were also assessed to see if they affected swallow and subsequent quality of life. Main outcome was measured using the MD Anderson Dysphagia Inventory questionnaire. Results: Responses were received from 46 males and 16 females (response rate of 80.5%) with a mean age of 64.7 years (SD 9.4). Median follow‐up in patients was 90 months (range 1–276). The mean MD Anderson Dysphagia Inventory total score in our series of patients was 77.7 (SD 16.6). MD Anderson Dysphagia Inventory global score was 79.4 (SD 22.6), Emotional score was 77.7 (SD 17.8), Functional score 81.3 (SD 15.9) and Physical score was 74.1(SD 18). Statistically significant differences were seen between the emotional scores of glossectomised and non‐glossectomised patients (Mann Whitney, P = 0.04). No significant correlation was seen between the subscale scores and the remaining treatment variables such as age, gender, site, tumour stage, myotomy, nerve implantation, radiotherapy, reconstruction and major complications. Conclusion: This questionnaire study is the largest of its type to assess the swallow of patients who have undergone laryngectomy at a single centre. The overall result confirmed that most patients had a subjectively good swallow. Only glossectomy and the method of PE segment closure were shown to significantly affect swallowing outcomes following surgery. We recommend further work especially prospective studies pre and post surgery using this or similarly validated instruments to fully assess swallow in the laryngectomy population.     

Local fibrinolysis for superior mesenteric artery thromboembolism

A 66-year-old man with atrial fibrillation was referred soon after developing left lower limb and abdominal pain with rectal bleeding. An immediate flush aortogram showed embolic occlusion of the left distal superficial femoral artery and superior mesenteric artery (SMA), 3 cm from its ostium. Recombinant tissue plasminogen activitor (rtPA) 40 mg was selectively in stilled in the SMA in two boluses. Abdominal symptoms resolved within 48 h, and complete recanalization of the SMA was shown on angiography. Exploratory laparotomy after 72 h showed a normal small bowel and right colon, and was completed by femoropopliteal embolectomy. Six months later, the patient remained asymptomatic.     

Efficient RT-PCR on platelet mRNA after long-term storage

We have developed a procedure permitting RT-PCR from mRNA even after a long-term storage (1 year) of platelet samples in ethanol (EtOH-platelets) at −80°C. To validate our method, we have analysed the human platelet alloantigen system (HPA-1) which is coded by β₃ mRNA. We have also demonstrated the efficiency of amplification of part of the coding region for (i) α_IIb subunit mRNA, (ii) α_v subunit mRNA, and (iii) the seven transmembrane domain thrombin receptor mRNA.