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      Doppler ultrasonographic evaluation of brachial and femoral veins, and coagulation and lipid profiles in dogs following open splenectomy

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          Abstract

          In dogs, splenectomy is mandatory as an emergency following splenic rupture with resultant hemoperitoneum and hypotensive shock. The present work aimed to evaluate the Doppler ultrasonographic parameters of brachial and femoral veins in splenectomized dogs and to investigate the effect of splenectomy on the coagulation and lipid profiles. A total number of 9 dogs underwent clinical, abdominal ultrasonographic and laboratory examinations prior to the surgical operation and kept for 60-day observation period post-splenectomy. Follow-up ultrasonography revealed no serious complications post-splenectomy. Both brachial and femoral veins were imaged medial to their corresponding arteries. Doppler ultrasonographic parameters of both veins showed no significant changes throughout the study period (P > 0.05). Haematological analysis revealed development of anemia, leukocytosis, and thrombocytosis in dogs post-splenectomy. Coagulation profile exhibited no significant variations in prothrombin and activated partial thromboplastin times (P > 0.05). In comparison with their baseline values, the mean concentrations of total cholesterol, low-density lipoprotein, and triglycerides were significantly increased 30-day post-splenectomy. In conclusion, it may seem that open splenectomy has no influence on the Doppler ultrasonographic indices of brachial and femoral veins with no evidence of deep vein thrombosis in dogs. However, persistent leukocytosis and thrombocytosis, as well as altered lipid profile may increase the risk of vascular complications with the long run. Therefore, a further long-term study may be required.

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          Most cited references41

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          How to interpret and pursue an abnormal prothrombin time, activated partial thromboplastin time, and bleeding time in adults.

          The prothrombin time (PT) and activated partial thromboplastin time (APTT) are among the most commonly ordered coagulation tests. In 2005, more than 140,000 PT and more than 95,000 APTT tests were performed at Mayo Clinic. The most common indications for ordering these tests include anticoagulant monitoring, initial evaluation of hemorrhage, and, although not generally indicated, routine preoperative screening. In addition, the bleeding time (BT) test, which is infrequently performed, is still available in certain institutions. Abnormal results from these tests (prolonged PT, APTT, and BT), especially from tests conducted for initial evaluation of hemorrhage or for preoperative screening, may pose a diagnostic dilemma to the nonhematologist. We review the essential factors affecting test results; provide a practical approach to the evaluation of a prolonged PT, APTT, and BT; and offer suggestions on which reflexive tests are appropriate and when to consider a subspecialty consultation.
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            Vascular complications after splenectomy for hematologic disorders.

            The most widely recognized long-term risk of splenectomy is overwhelming bacterial infection. More recently, thrombosis has become appreciated as another potential complication of the procedure. Because of these long-term risks, the indications for and timing of splenectomy are debated in the medical community. Accordingly, the adverse effects and benefits of splenectomy for hematologic disorders and other conditions demand further study. This comprehensive review summarizes the existing literature pertaining to vascular complications after splenectomy for hematologic conditions and attempts to define the potential pathophysiologic mechanisms involved. This complex topic encompasses diverse underlying conditions for which splenectomy is performed, diverse thrombotic complications, and multiple pathophysiologic mechanisms.
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              Prevalence of thromboembolic events among 8,860 patients with thalassaemia major and intermedia in the Mediterranean area and Iran.

              Beta-thalassaemia is a congenital haemolytic anaemia characterized by partial (intermedia, TI) or complete (major, TM) deficiency in the production of beta-globin chains. The primary aim of this study was to determine the prevalence of thromboembolic events in patients with beta-thalassaemia. To achieve this, a multiple choice questionnaire was sent to 56 tertiary referral centres in eight countries (Lebanon, Italy, Israel, Greece, Egypt, Jordan, Saudi Arabia and Iran), requesting specific information on patients who had experienced a thromboembolic event. The study demonstrated that thromboembolic events occurred in a clinically relevant proportion (1.65%) of 8,860 thalassaemia patients (TI - 24.7% or TM - 75.3%) from the Mediterranean and Iran. Thromboembolism occurred 4.38 times more frequently in TI than TM (p < 0.001), with more venous events occurring in TI and more arterial events occurring in TM. Thrombosis in thalassaemia was also more common in females, splenectomized patients and those with profound anaemia (haemoglobin <9 g/dl). Due to the increased risk of thromboembolic events, the rationale for splenectomy should perhaps be re-assessed and the role of transfusion therapy for the prophylaxis of thrombosis, among other complications, be evaluated prospectively.
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                Author and article information

                Contributors
                hhussein@aun.edu.eg
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                25 October 2019
                25 October 2019
                2019
                : 9
                : 15377
                Affiliations
                [1 ]ISNI 0000 0000 8632 679X, GRID grid.252487.e, Internal Veterinary Medicine, Department of Animal Medicine, , Faculty of Veterinary Medicine, Assiut University, ; Assiut, 71526 Egypt
                [2 ]ISNI 0000 0000 8632 679X, GRID grid.252487.e, Assistant Consultant of Surgery, , Anesthesiology and Radiology, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Assiut University, ; Assiut, 71526 Egypt
                [3 ]ISNI 0000 0000 8632 679X, GRID grid.252487.e, Department of Veterinary Pathology and Clinical Pathology, , Faculty of Veterinary Medicine, Assiut University, ; Assiut, 71526 Egypt
                [4 ]ISNI 0000 0000 8632 679X, GRID grid.252487.e, Department of Surgery, , Anesthesiology and Radiology, Director of Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Assiut University, ; Assiut, 71526 Egypt
                Author information
                http://orcid.org/0000-0003-0449-8283
                http://orcid.org/0000-0002-9753-5006
                http://orcid.org/0000-0001-6655-3570
                Article
                51924
                10.1038/s41598-019-51924-0
                6814893
                31653942
                f99b009d-c47b-41b3-85a5-7fa689a5140e
                © The Author(s) 2019

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 11 March 2019
                : 10 October 2019
                Categories
                Article
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                © The Author(s) 2019

                Uncategorized
                ultrasound,diseases
                Uncategorized
                ultrasound, diseases

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