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- Author or Editor: Trent T. Gall x
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Abstract
Objective—To evaluate fluid pressures generated via common wound-flushing techniques.
Sample Population—24 combinations of bottles, needles, a syringe, and a bag.
Procedures—12 medically trained individuals used the following devices to forcefully expel fluid as for wound flushing: full and half-full 1-L and 500-mL bottles with holes in the cap made with 16-, 18-, 20-, and 22-gauge needles; a 35-mL syringe with the same needle sizes; and a 1-L bag placed in a cuff pressurized to 300 mm Hg, with the same needle sizes. Fluid expulsion pressures were measured and compared.
Results—The highest pressure generated with the bottle was 3.90 — 1.30 psi (mean — SD) with a 16-gauge needle and a full 1-L bottle. The highest pressure generated with the 35-mL syringe was 18.40 — 9.80 psi with a 16-gauge needle. The lowest pressure generated with the 35-mL syringe was 16.70 — 6.50 psi with an 18-gauge needle. The bag under pressure generated a pressure of 7.3 — 0.1 psi with a 16-gauge needle. Needle size did not have a significant effect.
Conclusions and Clinical Relevance—Solution bottles of any size and needle gauge do not meet the requirement for satisfactory flushing pressure of 7 to 8 psi. Use of a 35-mL syringe can produce pressure substantially > 7 to 8 psi, which could damage tissues. The most consistent delivery method to generate 7 to 8 psi was use of a 1-L plastic bag within a cuff pressurized to 300 mm Hg.
Abstract
Objective—To determine the efficacy and toxic effects of epirubicin for the adjuvant treatment of dogs with splenic hemangiosarcoma and identify prognostic factors.
Design—Retrospective case series.
Animals—59 client-owned dogs that underwent splenectomy for splenic hemangiosarcoma treated with or without epirubicin.
Procedures—Medical records were examined for signalment, clinical signs, diagnostic and surgical findings, and postoperative outcome. For dogs treated with epirubicin, dose numbers, intervals, and reductions and type and severity of toxic effects were recorded. Dogs were allotted to 2 groups: splenectomy alone and splenectomy with adjuvant epirubicin treatment.
Results—18 dogs received epirubicin (30 mg/m2) every 3 weeks for up to 4 to 6 treatments. Forty-one dogs were treated with splenectomy alone. The overall median survival time was significantly longer in dogs treated with splenectomy and epirubicin (144 days), compared with splenectomy alone (86 days). Median survival time for dogs with stage I disease (345 days) was significantly longer than for dogs with either stage II (93 days) or III disease (68 days). Seven of 18 dogs treated with epirubicin were hospitalized for signs of adverse gastrointestinal effects. Inappetence, long duration of clinical signs, thrombocytopenia, neutrophilia, and high mitotic rate were negative prognostic factors.
Conclusions and Clinical Relevance—Epirubicin may be as efficacious as adjuvant doxorubicin-based protocols, but may result in a higher incidence of adverse gastrointestinal effects. Epirubicin should be considered as an alternative to doxorubicin in dogs with preexisting cardiac disease, as clinical epirubicin cardiotoxicity was not diagnosed in treated dogs.
