OBJECTIVE: To report the successful surgical management (open mitral commissurotomy, OMC) of mitral stenosis (MS), incorporating heart-beating cardiopulmonary bypass (CPB), in a 1-year-old dog. STUDY DESIGN: Clinical case. ANIMALS: One-year-old Cairn Terrier with MS. MATERIALS AND METHODS: Diagnosis of MS was confirmed by means of 2-dimensional, continuous-wave and color-flow Doppler echocardiography. Surgery was performed through a left intercostal thoracotomy. CPB was initiated and the heart was kept beating. The fused commissures of the mitral valve were incised to free the cusps of the valve. RESULTS: Left intercostal thoracotomy allowed easy observation of the mitral orifice during heart-beating OMC. Persistent bleeding from the atriotomy site required a second surgical procedure after which the dog had an uneventful recovery. Echocardiography at 2 weeks and 1 year postoperatively indicated substantial improvement in left ventricular filling (pressure half-time=187 ms before surgery, 105 ms [2 weeks] and 110 ms [1 year] after surgery). Enlargement of the left atrium resolved; however, moderate mitral valve regurgitation was still present. CONCLUSIONS: MS can be successfully treated by OMC, facilitated by use of CPB. Substantial improvement in cardiac function was evident by ultrasound and Doppler examination postoperatively. CLINICAL RELEVANCE: OMC under heart-beating CPB should be considered for the treatment of MS in the dog.

Animals↗

PubMedDate not supplied

Metabolic abnormalities in patients supported with enteral tube feeding.

One hundred patients supported with enteral tube feeding were evaluated for biochemical abnormalities. The following metabolic complications were observed: hyperglycemia (29%), hypoglycermia (2%) hypernatremia (10%), hyponatremia (31%), hyperkalemia (40%) hypokalemia (8%), hyperphosphatemia (14%) hypophosphatemia (30%) hypomagnesemia (3%), hypozincemia (11%), and hypocupremia (3%). Because of the extensive range of biochemical problems, it is recommended that subjects on tube feeding be evaluated periodically for metabolic abnormalities.

Copper↗

PubMedDate not supplied

Expectations and experiences of newly recruited Filipino nurses.

This article reports the preliminary results of a small study into the changing expectations of newly migrated Filipino nurses at a London hospital. The aim was to identify initial expectations and experiences. Focus group interviews were conducted with two groups of nurses shortly after their arrival. Career prospects and salaries were key factors influencing the decision to come to the UK. Differences emerged between the nurses' expectations of the nursing role and their actual experience on the wards. Adjusting to the new system of health care proved stressful but was helped by the provision of support services. Factors that may promote successful adaptation and retention included equal opportunities with respect to training and promotion and the use of culturally sensitive orientation programmes. Strategies to reduce social isolation may also be important. The results will be used to inform the trust's retention strategy and will also be of interest to other NHS trusts recruiting Filipino nurses and nurses from other countries.

Acculturation↗

PubMedDate not supplied

[The family physician dealing with children's sleep disorders].

Explore the source record for details and available documents.

Child↗