Dorothy Cimino Brown

Elanco (United States)

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Philipp D. Mayhew

University of California, Davis

Michael J. Iadarola

National Institutes of Health Clinical Center

Kimberly A. Agnello

University of Pennsylvania

Frances S. Shofer

University of Pennsylvania

William T. N. Culp

University of California, Davis

Andrew J. Mannes

National Institutes of Health Clinical Center

David E. Holt

University of Pennsylvania

John T. Farrar

University of Pennsylvania

Erika Krick

Hospital of the University of Pennsylvania

Raymond C. Boston

University of Melbourne

Cooperative Institutions

University of Pennsylvania

178

Hospital of the University of Pennsylvania

University of California, Davis

Philadelphia University

University College London

John Wiley & Sons (United States)

University of Florida

Veterinary Medical Teaching Hospital

Cornell University

California University of Pennsylvania

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The Effect of Laparoscopic Versus Open Ovariectomy on Postsurgical Activity in Small Dogs

Veterinary Surgery (2009)

William T. N. Culp Philipp D. Mayhew Dorothy Cimino Brown

Objective— To describe a technique for laparoscopic ovariectomy (LapOVE) in small dogs, and compare the surgical time, complications, and postoperative activity of dogs undergoing LapOVE to those undergoing conventional traditional open ovariectomy (OOVE). Study Design— A randomized, controlled clinical trial. Animals— Intact small breed (<10 kg) female dogs (n=20). Methods— Ventral median celiotomy was performed for OOVE. A 2‐midline portal technique using a 3.5 mm laparoscope port and a 6 mm instrument portal was used for LapOVE. An accelerometer was attached to the collar of each dog to record 24‐hour preoperative and 48‐hour postoperative activity. Total activity counts recorded before surgery were compared with total counts recorded after surgery. The percent change in counts after surgery was compared between OOVE‐ and LapOVE‐treated dogs. Results— No major complications occurred and surgical time for LapOVE was significantly longer than for OOVE cases ( P =.005). Dogs in the LapOVE group had a 25% decrease in total activity counts after surgery (95% confidence interval [CI]: 11–38%), whereas dogs in the OOVE group had a 62% decrease in total activity counts after surgery (95% CI: 48–76%). Conclusions— Both procedures were performed with reasonable surgical times and without major complication. Postoperative activity, as measured by accelerometry, was significantly different between the 2 groups. Clinical Relevance— Laparoscopy is a safe method for ovariectomy in small dogs and results in increased postoperative activity counts when compared with an open technique.

10.1111/j.1532-950x.2009.00572.x

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Citations (241)

LAVA: A Conceptual Framework for Automated Risk Analysis

Springer eBooks (1990)

S.T. Smith J.J. Lim John R. Phillips R.M. Tisinger Dorothy Cimino Brown

Vulnerability

Conceptual framework

Event tree

10.1007/978-1-4899-0759-2_37

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Citations (3)

The learning curve for veterinary surgery residents performing hemilaminectomy surgeries in dogs

Journal of the American Veterinary Medical Association (2017)

Owen T. Fink Raymond C. Boston Tracy Wu Dorothy Cimino Brown Jeffrey J. Runge

OBJECTIVE To describe the learning curve for veterinary surgery residents performing hemilaminectomy surgeries in dogs. DESIGN Retrospective case review and learning curve evaluation. SAMPLE 13 individuals who completed a 3-year surgery residency program at a university teaching hospital and who had no prior experience performing hemilaminectomies. PROCEDURES The 13 residents performed hemilaminectomies on 399 dogs between July 2006 and July 2013. Medical records were reviewed, and operative time was recorded. Data were examined with a linear mixed-effects model to quantify fixed and random effects, a curve-fitting technique to find the best-fit curve, and a segmented 2-phase linear model to describe the domains and learning rates for 2 phases of learning. RESULTS The linear mixed-effects model indicated that increasing patient body weight and increasing surgical complexity (graded on the basis of number and contiguity of hemilaminectomy sites) were associated with longer operative times and that increasing exposure number was associated with shorter operative times. The monoexponential and biexponential parametric curves were of similar quality in modeling the data. The segmented 2-phase linear model showed an early phase of learning during which operative time decreased rapidly and a late phase when operative time decreased more gradually. CONCLUSIONS AND CLINICAL RELEVANCE The learning curve for the residents suggested that for early exposures, instruction in the form of direct supervision provided substantial benefit. By the tenth exposure, the benefit of instruction diminished and ongoing improvement was primarily a result of refinement. If validated by further study, this understanding of a 2-phase learning curve may inform the design of training programs in veterinary surgery.

Learning curve

Medical record

Contiguity

10.2460/javma.250.2.215

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Citations (8)

Prospective Evaluation of Two Intracorporeally Sutured Prophylactic Laparoscopic Gastropexy Techniques Compared with Laparoscopic‐Assisted Gastropexy in Dogs

Veterinary Surgery (2009)

Philipp D. Mayhew Dorothy Cimino Brown

Objective— To report technique, surgical time, complication rate, and postoperative activity in dogs undergoing 2 intracorporeally‐sutured total laparoscopic gastropexy (TLG) techniques compared with a laparoscopic‐assisted gastropexy (LAG) technique. Study Design— Randomized clinical trial. Animals— Dogs (n=30) weighing >25 kg. Methods— Dogs were randomly assigned to 1 of 3 groups. Two TLG techniques were performed using a median 3 portal technique. One of 2 suturing techniques was used to approximate corresponding incisions made in the stomach and body wall; using intracorporeal hand‐suturing or a suture‐assist device (Endostitch ™ ). In a 3rd group, a previously reported LAG technique was used. All dogs had an activity monitor placed for 7 days pre‐ and postoperatively. Linear regression analyses were performed to evaluate the association of surgical procedure on gastropexy time and the percentage change in activity counts. Results— Median gastropexy time was 28 minutes (range, 20–41 minutes) for LAG, 48 minutes (range, 39–61 minutes) for the hand suture TLG technique, and 56 minutes (range, 30–90 minutes) for the Endostitch ™ TLG technique. LAG was performed faster than TLG ( P <.05). LAG dogs had a greater decrease in postoperative activity than TLG dogs ( P =.005); however there was no difference in surgical time or postoperative activity between TLG techniques. Conclusions— TLG can be performed safely and effectively in dogs and although it takes longer, it has less impact on postoperative activity compared with LAG. Clinical Relevance— TLG techniques may have advantages over LAG as measured by a greater willingness of dogs to move around postoperatively.

Gastropexy

10.1111/j.1532-950x.2009.00554.x

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Citations (96)

Survival times of and prognostic indicators for dogs with heart base masses: 25 cases (1986–1999)

Journal of the American Veterinary Medical Association (2001)

Erin D. Vicari Dorothy Cimino Brown David E. Holt Daniel J. Brockman

To determine survival times of and prognostic indicators for dogs with heart base masses.Retrospective study.25 dogs.Medical records were reviewed to obtain information regarding signalment; initial complaint; results of physical examination, radiography, electrocardiography, and echocardiography; surgical findings; medical and surgical treatment; outcome; necropsy findings; survival time; and cause of death.Survival time ranged from 0 to 1,096 days (mean, 213 days; median, 57 days). None of the variables examined, including initial complaints and results of physical examination, radiography, electrocardiography, and echocardiography, were associated with survival time. However, dogs that underwent pericardectomy had a significantly longer mean survival time (mean +/- SD, 661 +/- 170 days) than did dogs that were treated medically (129 +/- 51 days).Results suggest that dogs with heart base masses that undergo pericardectomy may survive longer than those that receive medical treatment alone.

Medical record

Medical treatment

10.2460/javma.2001.219.485

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Citations (69)

Evaluation of the learning curve for a board-certified veterinary surgeon performing laparoendoscopic single-site ovariectomy in dogs

Journal of the American Veterinary Medical Association (2014)

Jeffrey J. Runge Raymond C. Boston Sharona Ross Dorothy Cimino Brown

Abstract Objective —To define the learning curve and evaluate the outcome for a board-certified veterinary surgeon performing laparoendoscopic single-site (LESS) ovariectomy in dogs. Design —Retrospective case review and learning curve evaluation with a skill acquisition model. Animals —27 client-owned dogs. Procedures —Between April 2011 and December 2012, 27 dogs underwent elective LESS ovariectomy performed by a single experienced board-certified laparoscopic surgeon by means of the same technique. Medical records for these patients were reviewed to determine whether a learning curve could be detected. A commercially available multitrocar port was inserted through a 15- to 20-mm incision at the umbilicus, and LESS ovariectomy was performed with articulating graspers, a bipolar vessel-sealing device, and a 30° telescope. Surgical performance of the surgeon was quantified with an exponential skill acquisition model, and how skill was gained with repetition of the same novel surgical procedure was examined. Results —Median patient body weight was 20 kg (44 lb; range, 3.5 to 41 kg [7.7 to 90.2 lb]). Median surgical time was 35 minutes (range, 20 to 80 minutes). Median patient age was 314 days (range, 176 to 2,913 days). The skill acquisition model revealed that a comparable surgeon could reach 90% of optimal surgery performance after approximately 8 procedures (8.6, 95% confidence interval, 0.5 to 16.6 procedures). According to the model, with each surgery, surgical time would be expected to decrease by 27% (95% confidence interval, 2% to 52%). Complications were limited to minor hemorrhage due to a splenic laceration and a postoperative incisional infection. Follow-up information was available for all 27 cases. All owners were satisfied and indicated that they would pursue LESS ovariectomy again. Conclusions and Clinical Relevance —The learning curve for LESS ovariectomy was short and definable. Short-term outcome was excellent. Results of this study suggested that an experienced laparoscopic surgeon may anticipate achieving proficiency with this technique after performing approximately 8 procedures.

Learning curve

10.2460/javma.245.7.828

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Citations (36)

TREATMENT OF ADOLESCENT MALES WITH CONSTITUTIONAL DELAY OF GROWTH AND PUBERTY (CDGP) WITH SUBLINGUAL TESTOSTERONE (SL-T) COMPLEXED WITH HYDROXYPROPYL-β-CYCLODEXTRIN (HPBCD)

Pediatric Research (1993)

Pinchas Cohen Dorothy Cimino Brown Robert E. Dudley R G Rosenfeld

Regimen

Sexual maturity

10.1203/00006450-199305001-00493

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Citations (0)

Body Weight as a Predisposing Factor for Humeral Condylar Fractures, Cranial Cruciate Rupture and Intervertebral Disc Disease in Cocker Spaniels

Veterinary and Comparative Orthopaedics and Traumatology (1996)

Michael G. Conzemius Frances S. Shofer Dorothy Cimino Brown

Summary The purpose of this study was to determine whether or not body weight is a risk factor for humeral condylar fractures (HCF), cranial cruciate rupture (CCR) or intervertebral disc disease (IVDD) in the American Cocker Spaniel dog. Body weight, age, sex and recorded diagnoses of 854 Cocker Spaniels admitted to the teaching hospital, over a four-year period, were recorded from medical records. Dogs with a diagnosis of HCF (n = 21) weighed significantly more than the general population of Cocker Spaniels seen at the hospital over the same time period. Dogs with CCR (n = 20) were likely to weigh more than the general population. Whereas, dogs with IVDD (n = 47) weighed less than the general population of Cocker Spaniels. From these results, we concluded that body weight is a predisposing factor for HCF in Cocker Spaniels; that there is a tendency for Cocker Spaniels with CCR to be heavier than the general population and that being overweight does not predispose them to IVDD. Body weight, age, sex, and diagnoses of 854 Cocker Spaniels admitted over four years were recorded. Dogs with humeral condylar fractures weighed significantly more than the general population of Cocker Spaniels admitted over the same time period. Dogs with cruciate rupture weighed more, on average, than the general population of Cocker Spaniels, but surprisingly, dogs with intervertebral disc disease weighed less.

10.1055/s-0038-1632506

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Citations (31)

Investigating Associations Between Proliferation Indices, C-kit, and Lymph Node Stage in Canine Mast Cell Tumors

Journal of the American Animal Hospital Association (2017)

Erika Krick Matti Kiupel Amy C. Durham Tuddow Thaiwong Dorothy Cimino Brown

Previous studies have evaluated cellular proliferation indices, KIT expression, and c-kit mutations to predict the clinical behavior of canine mast cell tumors (MCTs). The study purpose was to retrospectively compare mitotic index, argyrophilic nucleolar organizer regions (AgNORs)/nucleus, Ki-67 index, KIT labeling pattern, and internal tandem duplication mutations in c-KIT between stage I and stage II grade II MCTs. Medical records and tumor biopsy samples from dogs with Grade II MCTs with cytological or histopathological regional lymph node evaluation were included. Signalment, tumor location and stage, and presence of a recurrent versus de novo tumor were recorded. Mitotic index, AgNORs/nucleus, Ki-67, KIT staining pattern, and internal tandem duplication mutations in exon 11 of c-KIT were evaluated. Sixty-six tumors (51 stage I; 15 stage II) were included. Only AgNORs/nucleus and recurrent tumors were significantly associated with stage (odds ratio 2.8, 95% confidence interval [CI] 1.0-8.0, P = .049; odds ratio 8.8, 95% CI 1.1-69.5; P = .039). Receiver-operator characteristic analysis showed that the sensitivity and specificity of AgNORs/cell ≥ 1.87 were 93.3% and 27.4%, respectively, (area under the curve: 0.65) for predicting stage. Recurrent tumors and higher AgNORs/nucleus are associated with stage II grade II MCTs; however, an AgNOR cutoff value that reliably predicts lymph node metastasis was not determined.

Proliferation index

Mitotic index

10.5326/jaaha-ms-6265

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Citations (11)

Thoracoscopic Subphrenic Pericardectomy Using Double-Lumen Endobronchial Intubation for Alternating One-Lung Ventilation

Veterinary Surgery (2009)

Kelli N. Mayhew Philipp D. Mayhew Laurie Sorrell-Raschi Dorothy Cimino Brown

Objective— To report the technique, complications, and effectiveness of thoracoscopic subphrenic pericardectomy (SPP) using double‐lumen endobronchial intubation for alternating 1‐lung (OLV) in healthy dogs. Study Design— Prospective cohort study. Animals— Mature purpose‐bred dogs (n=7). Methods— Bronchoscope‐assisted placement of a left‐sided double‐lumen endobronchial tube, immediately before surgery, allowed intraoperative alternation of ventilation between lung fields. A camera portal was established in a subxyphoid location. Two instrument portals were established at the 4th–6th intercostal spaces on the right and left sides. A vessel‐sealing device was used to create the subphrenic pericardectomy. After termination of the procedure, dogs were humanely euthanatized under anesthesia and necropsy performed. In each dog, the extent of pericardectomy and any complications were evaluated. Results— Technical difficulties with tube placement occurred in 4 dogs, but alternating OLV was achieved in all dogs and SPP completed successfully. Median surgical time was 87.5 minutes (range, 80–105 minutes). At necropsy, 0.5–2 cm of pericardial tissue remained ventral to the intact phrenic nerve in 6 dogs; in 1 dog, the phrenic nerve was transected on the left side only. Conclusions— Thoracoscopic subphrenic pericardectomy is a technically feasible procedure in healthy dogs. Double‐lumen endobronchial intubation allowed alternating OLV without intraoperative bronchoscopically guided tube manipulation in all but 1 dog. Clinical Relevance— Thoracoscopic subphrenic pericardectomy could potentially be used for management of conditions where relief of pericardial constriction or access to intrapericardial structures is desired.

Lumen (anatomy)

10.1111/j.1532-950x.2009.00583.x

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Citations (55)