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Article: Sustainable Hand Surgery: Incorporating Water Efficiency Into Clinical Practice.

Gasson, Sophie / Solari, Francesca / Jesudason, Edwin P

2023 Volume 15, Issue 4, Page(s) e38331

Abstract: Introduction Public health and well-being outcomes are intimately connected with the health of our planet. Climate change has numerous far-reaching effects. Managing and mitigating these risks to human health presents one of the next challenges to global ...

Abstract	Introduction Public health and well-being outcomes are intimately connected with the health of our planet. Climate change has numerous far-reaching effects. Managing and mitigating these risks to human health presents one of the next challenges to global healthcare. The current usage of planetary resources is unsustainable. Surgical procedures are particularly resource-intensive, often utilising vast amounts of single-use consumables, like water. In the last 100 years global usage of fresh water has increased six-fold and continues to rise by 1% year on year. It is well established that initial hand sterilization and maintenance of hand sterility during the surgical list are essential for preventing hospital-acquired infections and associated morbidity and mortality. This study aims to estimate the current daily water usage of two typical hand surgery lists from a District General Hospital in North Wales, to determine potential water savings by switching exclusively to an alcohol-based hand rub for subsequent scrubs, in line with current national guidelines. Methods Observational study estimation of water consumption from a temperature-controlled manual tap required using a 1 litre volumetric jug where the time taken to fill was recorded. Three separate observational samples were taken, and a mean was calculated. This mean determined the amount of water dispensed from the tap in a standard 3 min scrub and subsequent 1 min scrub. Two different theatre schedules were analysed: 1. A trauma list (five cases) and 2. A higher volume minor elective procedure schedule (16 cases), in this case a wide-awake local anaesthetic no tourniquet (WALANT) carpal tunnel release (CTR). Results Each case regardless of procedure had approximately three persons scrubbed. 20.57L of water is used for one person to scrub for 3 mins and an extra 6.8574L for each subsequent 1 min scrub. Therefore, current daily water consumption could reach 143.99L during the major hand trauma list and 411.4L during a high-volume carpal tunnel release list. Conclusion Simply following current guidelines by switching to alcohol-based hand rub just for subsequent scrubs could reduce water consumption by 57.2% for hand trauma lists and 70.2% for high-volume CTR lists.
Language	English
Publishing date	2023-04-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.38331
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Article ; Online: Percutaneous transvenous coil embolization of an extrahepatic portosystemic shunt in a cat.

Case, J Brad / Solari, Francesca P / Vilaplana Grosso, Federico

JFMS open reports

2022 Volume 8, Issue 2, Page(s) 20551169221126381

Abstract: Case summary: A 10-month-old male domestic shorthair cat presented for surgical treatment of a congenital portosystemic shunt. The cat had a history of lethargy and ptyalism. Pre- and postprandial bile acids were markedly elevated. CT was performed, ... ...

Abstract	Case summary: A 10-month-old male domestic shorthair cat presented for surgical treatment of a congenital portosystemic shunt. The cat had a history of lethargy and ptyalism. Pre- and postprandial bile acids were markedly elevated. CT was performed, which revealed a single, congenital, left gastrophrenic, extrahepatic portosystemic shunt. A minimally invasive surgical approach was considered by transjugular percutaneous coil embolization of the venous shunt, which was performed without complications. Follow-up protein C and serum biochemical analyses were performed at 1, 2 and 5 months postoperatively, and were improved. The cat is alive and clinically normal 11 months postoperatively. Relevance and novel information: This is the first report of percutaneous transvenous coil embolization for the treatment of an extrahepatic portosystemic shunt in a cat. The outcome was excellent in this patient, with no complications and complete resolution of clinical signs.
Language	English
Publishing date	2022-10-10
Publishing country	England
Document type	Case Reports
ZDB-ID	2822177-1
ISSN	2055-1169 ; 2055-1169
ISSN (online)	2055-1169
ISSN	2055-1169
DOI	10.1177/20551169221126381
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Article ; Online: Diagnosis and successful management of an extradural compressive hematoma secondary to diphacinone poisoning in a dog

Solari, Francesca P. / Sherman, Alec H. / Blong, April E. / Cameron, Starr / Walton, Rebecca A.

Journal of Veterinary Emergency and Critical Care. 2023 Jan., v. 33, no. 1 p.101-106

2023

Abstract: OBJECTIVE: To describe the successful case management of an extradural hematoma secondary to anticoagulant rodenticide toxicity causing spinal compression and paraplegia. CASE SUMMARY: A 3‐month‐old, female intact, mixed breed dog was presented for a 12‐ ... ...

Abstract	OBJECTIVE: To describe the successful case management of an extradural hematoma secondary to anticoagulant rodenticide toxicity causing spinal compression and paraplegia. CASE SUMMARY: A 3‐month‐old, female intact, mixed breed dog was presented for a 12‐hour history of paraplegia. CBC and biochemistry results were unremarkable, and a coagulation panel revealed prolonged prothrombin time with normal activated partial thromboplastin time. Magnetic resonance imaging revealed an extradural compressive lesion within the vertebral canal extending from T6 to T11, most consistent with an extradural hematoma. Further coagulation testing revealed a coagulopathy caused by vitamin K1 deficiency and confirmed exposure to the anticoagulant rodenticide, diphacinone. The dog was medically managed with fresh frozen plasma, aminocaproic acid, and oral vitamin K1 therapy. A right‐sided T6 to T11 hemilaminectomy was later performed for removal of the extradural hematoma and spinal decompression. The dog's neurological status gradually improved postoperatively and, at the time of discharge, was nonambulatory paraparetic with voluntary micturition. Four weeks postoperatively, the dog had normal prothrombin and activated partial thromboplastin times and was nonambulatory paraparetic with strong motor function. NEW OR UNIQUE INFORMATION PROVIDED: This is the first reported case of a dog with an extradural hematoma secondary to anticoagulant rodenticide causing spinal cord compression and neurological deficits. Surgical management of this case was successful and resulted in improvement of neurological signs. Extradural hematoma should be considered as a potential location of bleeding in rodenticide toxicity as well as a differential diagnosis in patients with neurological deficits.
Keywords	coagulation ; diphacinone ; dogs ; females ; hematoma ; magnetism ; phylloquinone ; prothrombin ; spinal cord ; surgery ; thromboplastin ; toxicity
Language	English
Dates of publication	2023-01
Size	p. 101-106.
Publishing place	John Wiley & Sons, Ltd
Document type	Article ; Online
Note	Case Reports
ZDB-ID	2077212-9
ISSN	1476-4431 ; 1479-3261
ISSN (online)	1476-4431
ISSN	1479-3261
DOI	10.1111/vec.13248
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Article ; Online: Retroperitoneal hematoma after dorsal quadratus lumborum block in two dogs.

Chiavaccini, Ludovica / Solari, Francesca P / Ham, Kathleen M / Regier, Penny J / Vettorato, Enzo / Portela, Diego A

Veterinary anaesthesia and analgesia

2023 Volume 51, Issue 1, Page(s) 112–114

MeSH term(s)	Dogs ; Animals ; Nerve Block/adverse effects ; Nerve Block/veterinary ; Abdominal Muscles ; Hematoma/etiology ; Hematoma/veterinary ; Pain, Postoperative/veterinary ; Ultrasonography, Interventional/veterinary ; Dog Diseases/etiology ; Dog Diseases/surgery
Language	English
Publishing date	2023-11-07
Publishing country	United States
Document type	Letter
ZDB-ID	2020582-X
ISSN	1467-2995 ; 1467-2987
ISSN (online)	1467-2995
ISSN	1467-2987
DOI	10.1016/j.vaa.2023.11.002
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Article ; Online: Percutaneous transvenous coil embolization of an extrahepatic portosystemic shunt in a cat

Case, J. Brad / Solari, Francesca P / Vilaplana Grosso, Federico

Journal of Feline Medicine and Surgery Open Reports. 2022 Oct., v. 8, no. 2 p.20551169221126381-

2022

Abstract: A 10-month-old male domestic shorthair cat presented for surgical treatment of a congenital portosystemic shunt. The cat had a history of lethargy and ptyalism. Pre- and postprandial bile acids were markedly elevated. CT was performed, which revealed a ... ...

Abstract	A 10-month-old male domestic shorthair cat presented for surgical treatment of a congenital portosystemic shunt. The cat had a history of lethargy and ptyalism. Pre- and postprandial bile acids were markedly elevated. CT was performed, which revealed a single, congenital, left gastrophrenic, extrahepatic portosystemic shunt. A minimally invasive surgical approach was considered by transjugular percutaneous coil embolization of the venous shunt, which was performed without complications. Follow-up protein C and serum biochemical analyses were performed at 1, 2 and 5 months postoperatively, and were improved. The cat is alive and clinically normal 11 months postoperatively. This is the first report of percutaneous transvenous coil embolization for the treatment of an extrahepatic portosystemic shunt in a cat. The outcome was excellent in this patient, with no complications and complete resolution of clinical signs.
Keywords	bile ; blood serum ; cats ; males ; medicine ; patients ; surgery ; Portosystemic shunt ; liver ; embolization ; interventional radiology
Language	English
Dates of publication	2022-10
Publishing place	SAGE Publications
Document type	Article ; Online
ZDB-ID	2822177-1
ISSN	2055-1169
ISSN	2055-1169
DOI	10.1177/20551169221126381
Database	NAL-Catalogue (AGRICOLA)

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Article: Rationalization of Orthopaedic Surgical Instrument Trays: Three Years' Experience of a Practical Approach to Cut Down Unnecessary Costs.

Hermena, Shady / Solari, Francesca / Whitham, Robert / Hatcher, Cara / Donaldson, Oliver

Cureus

2021 Volume 13, Issue 11, Page(s) e19866

Abstract: Background This study aimed to rationalize the surgical instrument trays (SITs) used in some trauma and orthopedic (T&O) procedures to reduce unnecessary costs. Methods SITs for several T&O procedures at our trust were assessed to judge the utility of ... ...

Abstract	Background This study aimed to rationalize the surgical instrument trays (SITs) used in some trauma and orthopedic (T&O) procedures to reduce unnecessary costs. Methods SITs for several T&O procedures at our trust were assessed to judge the utility of each instrument. SITs for hip, knee, and shoulder arthroscopy, dynamic hip screw (DHS), rotator cuff repair, shoulder stabilization, total shoulder arthroplasty (TSR), and proximal humerus fracture fixation were reviewed. Infrequently used and irrelevant instruments were removed to minimize the number of used trays for each procedure. A qualitative survey was conducted following SIT rationalization to assess the practicality and suitability of these changes. Results The number of SITs was rationalized from four to two for DHS, three to one for hip, knee, and shoulder arthroscopy, five to two for rotator cuff repair and shoulder stabilization, three to one for TSR, and proximal humerus fracture fixation. Based on the local database figures for these procedures, the estimated number of used trays reduced from 2,785 to 1.015 (36.4%) trays per year. Based on the sterilization cost of £35 per tray, annual savings amounted to about £61,950. Qualitative analysis of theatre staff feedback showed increased time efficiency and a positive feeling of practicality. Conclusion The critical appraisal of the departmental operating practice is an effective tool to achieve cost-efficient practice. The rationalization of SITs for orthopedic procedures can result in significant savings by reducing sterilization costs alone.
Language	English
Publishing date	2021-11-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.19866
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Article ; Online: Percutaneous transvenous coil embolization of congenital intrahepatic portosystemic shunts in small- and toy-breed dogs: 20 cases (2015-2021).

Solari, Francesca P / Culp, William T N / Vilaplana Grosso, Federico R / Case, J Brad

Journal of the American Veterinary Medical Association

2022 Volume 260, Issue 12, Page(s) 1526–1532

Abstract: Objective: To describe outcomes of small- and toy-breed dogs with a congenital intrahepatic portosystemic shunt (IHPSS) treated with percutaneous transvenous coil embolization (PTCE).: Animals: 20 small- and toy-breed dogs with an IHPSS.: ... ...

Abstract	Objective: To describe outcomes of small- and toy-breed dogs with a congenital intrahepatic portosystemic shunt (IHPSS) treated with percutaneous transvenous coil embolization (PTCE). Animals: 20 small- and toy-breed dogs with an IHPSS. Procedures: All dogs underwent CT angiography for shunt evaluation as well as PTCE. Medical records were reviewed for pertinent data, and owners and primary veterinarians were contacted for long-term follow-up information. Results: Dogs ranged from 1.5 to 10.0 kg (mean ± SD, 6.32 ± 2.57 kg) in weight. The equipment used to perform PTCE tended to be smaller than that previously described for larger breed dogs. Intra- and postoperative complication rates were 20% (4/20) and 5% (1/20), respectively, and included hypotension, bradycardia, hypercapnia, ventricular premature contractions, hypothermia, and regurgitation. Dogs were discharged a median of 3 days (range, 1 to 3 days) after surgery, and all dogs survived to discharge. Clinical signs resolved in 95% (19/20) of the dogs a median of 21 days after the procedure. One- and 2-year survival rates were 92%. Three dogs had died by the time of data collection; 2 of these dogs died of causes related to the IHPSS 267 and 1,178 days, respectively, after the procedure. Clinical relevance: Percutaneous transvenous coil embolization was a safe and effective option for treatment of IHPSS in small- and toy-breed dogs and offered a minimally invasive alternative to open surgical techniques. Complication and survival rates in this cohort were similar to or better than those reported in previous studies evaluating PTCE and open surgical techniques for treatment of IHPSS in dogs.
MeSH term(s)	Animals ; Dogs ; Computed Tomography Angiography/veterinary ; Dog Diseases/surgery ; Portal System/abnormalities ; Portal System/surgery ; Portal Vein/abnormalities ; Portal Vein/surgery ; Portasystemic Shunt, Transjugular Intrahepatic/veterinary ; Retrospective Studies ; Embolization, Therapeutic/veterinary
Language	English
Publishing date	2022-07-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	390811-2
ISSN	1943-569X ; 0003-1488
ISSN (online)	1943-569X
ISSN	0003-1488
DOI	10.2460/javma.22.03.0143
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Article ; Online: Diagnosis and successful management of an extradural compressive hematoma secondary to diphacinone poisoning in a dog.

Solari, Francesca P / Sherman, Alec H / Blong, April E / Cameron, Starr / Walton, Rebecca A

Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)

2022 Volume 33, Issue 1, Page(s) 101–106

Abstract: Objective: To describe the successful case management of an extradural hematoma secondary to anticoagulant rodenticide toxicity causing spinal compression and paraplegia.: Case summary: A 3-month-old, female intact, mixed breed dog was presented for ... ...

Abstract	Objective: To describe the successful case management of an extradural hematoma secondary to anticoagulant rodenticide toxicity causing spinal compression and paraplegia. Case summary: A 3-month-old, female intact, mixed breed dog was presented for a 12-hour history of paraplegia. CBC and biochemistry results were unremarkable, and a coagulation panel revealed prolonged prothrombin time with normal activated partial thromboplastin time. Magnetic resonance imaging revealed an extradural compressive lesion within the vertebral canal extending from T6 to T11, most consistent with an extradural hematoma. Further coagulation testing revealed a coagulopathy caused by vitamin K1 deficiency and confirmed exposure to the anticoagulant rodenticide, diphacinone. The dog was medically managed with fresh frozen plasma, aminocaproic acid, and oral vitamin K1 therapy. A right-sided T6 to T11 hemilaminectomy was later performed for removal of the extradural hematoma and spinal decompression. The dog's neurological status gradually improved postoperatively and, at the time of discharge, was nonambulatory paraparetic with voluntary micturition. Four weeks postoperatively, the dog had normal prothrombin and activated partial thromboplastin times and was nonambulatory paraparetic with strong motor function. New or unique information provided: This is the first reported case of a dog with an extradural hematoma secondary to anticoagulant rodenticide causing spinal cord compression and neurological deficits. Surgical management of this case was successful and resulted in improvement of neurological signs. Extradural hematoma should be considered as a potential location of bleeding in rodenticide toxicity as well as a differential diagnosis in patients with neurological deficits.
MeSH term(s)	Dogs ; Female ; Animals ; Rodenticides ; Vitamin K 1 ; Anticoagulants ; Paraplegia/veterinary ; Hematoma/veterinary ; Dog Diseases/chemically induced ; Dog Diseases/diagnosis ; Dog Diseases/pathology
Chemical Substances	Rodenticides ; diphenadione (54CA01C6JX) ; Vitamin K 1 (84-80-0) ; Anticoagulants
Language	English
Publishing date	2022-09-13
Publishing country	United States
Document type	Case Reports
ZDB-ID	2077212-9
ISSN	1476-4431 ; 1479-3261
ISSN (online)	1476-4431
ISSN	1479-3261
DOI	10.1111/vec.13248
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Article ; Online: Correction: Fetal cell microchimerism and susceptibility to COVID-19 disease in women.

Cirello, Valentina / Lugaresi, Marina / Manzo, Alessandro / Balla, Eva / Fratianni, Gerardina / Solari, Francesca / Persani, Luca / Fugazzola, Laura / Campi, Irene

Infection

2023 Volume 51, Issue 4, Page(s) 1079

Language	English
Publishing date	2023-05-11
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	185104-4
ISSN	1439-0973 ; 0300-8126 ; 0173-2129
ISSN (online)	1439-0973
ISSN	0300-8126 ; 0173-2129
DOI	10.1007/s15010-023-02037-4
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Article ; Online: Fetal cell microchimerism and susceptibility to COVID-19 disease in women.

Cirello, Valentina / Lugaresi, Marina / Manzo, Alessandro / Balla, Eva / Fratianni, Gerardina / Solari, Francesca / Persani, Luca / Fugazzola, Laura / Campi, Irene

Infection

2023 Volume 51, Issue 4, Page(s) 1071–1078

Abstract: Purpose: The clinical outcome of COVID-19 disease is worse in males, and the reasons of this gender disparity are currently unclear, though evidences point to a combination of biological and gender-specific factors. A phenomenon unique to the female ... ...

Abstract	Purpose: The clinical outcome of COVID-19 disease is worse in males, and the reasons of this gender disparity are currently unclear, though evidences point to a combination of biological and gender-specific factors. A phenomenon unique to the female gender is the fetal cell microchimerism (FCM), defined as the presence of fetal microchimeric cells in maternal organs and in the circulation for years after delivery and usually evaluated by assessing the presence of male cells or DNA in a woman. In the present case-control study, we aimed to evaluate the possible effect of pregnancy and related FCM on the susceptibility to SARS-CoV-2 infection and on the clinical course and outcome of COVID-19. Methods: One hundred twenty-three women with a previous male pregnancy, comprising 63 COVID-19 cases and 60 healthy controls were enrolled. The presence of blood male DNA was assessed by the amplification of the Y-chromosome specific gene SRY. Results: The prevalence of male DNA of presumed fetal origin was significantly higher in healthy controls than in COVID-19 cases (70 vs 44.4%, P = 0.0044; OR 0.3429, 95% CI 0.1631-0.7207, P = 0.0047). Among women affected with COVID-19, the presence of male FCM did not significantly influence the severity of the disease, though the 8 deceased women studied were all FCM negative. Conclusion: This is the first case-control study reporting the prevalence of FCM in COVID-19 and healthy women. Overall, our data seem to suggest a role for FCM in the protection towards the SARS-CoV-2 infection with a possible positive impact on clinical outcome.
MeSH term(s)	Pregnancy ; Humans ; Male ; Female ; COVID-19/epidemiology ; Chimerism ; Case-Control Studies ; SARS-CoV-2 ; DNA
Chemical Substances	DNA (9007-49-2)
Language	English
Publishing date	2023-03-01
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	185104-4
ISSN	1439-0973 ; 0300-8126 ; 0173-2129
ISSN (online)	1439-0973
ISSN	0300-8126 ; 0173-2129
DOI	10.1007/s15010-023-02006-x
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