Biomedical subjects
Publications and source records attributed to H Featherstone.
Six horses with keratomycosis were examined and three different clinical expressions of the disease were recognised. The diagnostic work-up and response to treatment is described.
A swelling ventromedial to the left eye of a one-year-old, neutered male Labrador failed to respond to antibiotic and anti-inflammatory therapy. Plain and contrast radiography revealed a spherical, radiolucent area, 1.5 cm in diameter, dorsomedial to the fourth maxillary premolar and rostral to the ethmoid region. The lesion was thin-walled, with a smooth radiopaque margin, and was clearly demarcated from the surrounding structures. Dacryocystography demonstrated no apparent physical association between the lesion and the nasolacrimal duct, the latter appearing normal. Ultrasonography of the lesion showed a round, anechoic structure consistent with the appearance of a cyst. Prior to surgical excision of the lesion, intralesional fluid was aspirated. Bacteriology of the fluid was negative for both aerobic and anaerobic organisms. Cytological examination of the fluid showed a few macrophages and small lymphocytes; neither significant inflammatory component nor neoplastic cells were found. Histology showed the lesion to be a benign epithelial cyst. The dog recovered uneventfully and there was no clinical evidence of recurrence within a two-year follow-up period.
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Two cases of pyogranulomatous blepharitis (inflammation of the lid margins) in the dalmatian are described. The diagnosis was confirmed on biopsy of the lid lesions. Bacteriology performed in one case was negative. Both cases responded to treatment: one responded well to a course of systemic steroids (prednisolone 1 mg/kg at a decreasing dose over three weeks), while the other, which was negative on culture, responded to a six-week course of cephalexin (30 mg/kg twice daily). This second dog also presented with a localised lymphadenopathy; the owner had suffered a similar reaction three years previously as a result of a penetrating injury by a pyracantha thorn.
The management of patients with critical major airways obstruction has been made possible by the recent introduction of expandable metal stents as the sole treatment or as an adjunct to other treatment modalities, to alleviate the distressing symptoms from tracheobronchial obstructions Gianturco self-expanding stents were used successfully in the management of 27 patients. The indications were: stenosis from postoperative strictures and recurrent tumours (n = 6), extrinsic compression from metastatic disease (n = 9), inoperable primary tumours of central airways (n = 9), airway collapse from relapsing polychondritis (n = 1), excessive mediastinal shift following right pneumonectomy (n = 1) and endobronchial non-Hodgkin's lymphoma (n = 1). Twenty three patients had immediate relief of stridor and the remaining two patients were successfully weaned from ventilatory support. There were two postoperative deaths. The stents were inserted under general anaesthesia through a rigid bronchoscope under direct vision. The ease of insertion under radiological control, self-expanding nature of the stents and the lack of major complications on follow-up of up to 47 months are particular advantages. The self-expanding tracheobronchial stents are a useful addition to our armamentarium in maintenance of the airways in patients with major airway stenosis and collapse.
Two rare cases of organic outlet obstruction of intrathoracic stomach following Ivor Lewis oesophagectomy are presented. Aetiology and the management of the same is discussed.
Oxfendazole, formulated into a 22.5% suspension, was administered by intraruminal injection to cattle at the rates of 0, 1.125, 2.25, 4.50, and 6.75 mg/kg of body weight. In total, 50 naturally infected calves were used, with 10 animals being allocated to each of the 5 treatment groups on the basis of pretreatment counts of nematode eggs per gram of feces. All animals were necropsied 7 days after treatment. The trial was done between December 1983 and January 1984, with the animals kept on concrete for a minimum of 35 days immediately before necropsy. For all nematodes and stages combined, efficacies were 97.4%, 98.8%, 99.5%, and 99.8% for oxfendazole at dosages of 1.125, 2.25, 4.50, and 6.75 mg/kg of body weight, respectively. Early 4th-stage larvae of Ostertagia and Nematodirus helvetianus adults were eliminated at rates greater than 93% only at the dosages of 4.50 mg/kg and above. Local or systemic adverse reactions were not observed in any of the animals.
Sixteen sheep harboring naturally acquired parasitisms were allocated to 1 of 2 treatment groups: (i) sheep given ivermectin in an oral solution at the dosage rate of 200 micrograms/kg of body weight, and (ii) those given the vehicle at a dosage rate of 0.25 ml/kg. All animals were necropsied at 2 weeks after treatment. Parasites and percentages of parasitic reductions, as demonstrated in this trial, were: Dictyocaulus filaria (99.4%), Oestrus ovis first stage instars (100%), Trichuris ovis (98.9%), Strongyloides papillosus (99.8%), Nematodirus spathiger (100%), arrested 4th stage Nematodirus spp (96.2%), Trichostrongylus colubriformis (100%), T axei (100%), Oster tagia circumcincta (100%), Haemonchus contortus (100%), and arrested Haemonchus spp 4th stage larvae (99.9%). The sheep showed no adverse effects due to ivermectin or vehicle administration.
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The Department of Medicine at the University of Washington has reorganized its residency program to increase the emphasis on general internal medicine and primary care. New teaching services in community hospitals have been established, clinical training sites in Montana, Idaho and Eastern Washington opened, and primary care residency tracks begun. Current data indicate that a major shift in the career plans of our new residents also has occurred. Whereas a decade ago approximately two thirds of our residents were becoming subspecialists, almost two thirds of our 1979 and 1980 program graduates are headed towards careers as general internists. Many will practice in the region's smaller cities and towns. The program serves as a model for the development of a regional program for graduate training in internal medicine.
Geriatric and Family Services at the University of Washington provides a comprehensive evaluation and treatment program for the impaired elderly, and also offers support, counseling and practical advice for their families. Although most of the 76 patients in this first-year study had cognitive impairment, about one-fourth of them showed unequivocal motor, cognitive and/or affective improvement with treatment for previously undetected illnesses. The rating of "unequivocal improvement" required objective data, as well as corroboration by the patient and family. These therapeutic gains and the increased public interest led to expansion of the program.
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