This kind of training also allowed to reach a 97 % consistency rate among HPs as compared to USS, while the lack of training was associated with a wide variability and inconsistency of identification results. ResultsA specific training allowed inexperienced HPs to acquire high diagnostic accuracy in identifying LH lesions independent of site, size, shape, and even BMI. Each was blindly examined by four well trained and four non-trained HPs according to a standard method involving repeated well codified maneuvers. Out of 129 insulin-treated people with diabetes identified by USS as having LH lesions, only 40 agreed to participate in the study (24 females, age 54 ± 15 years, daily insulin dosage 57 ± 12 IU). AimsTo define a structured method allowing health professionals (HPs) to identify LH lesions as inexpensively and correctly as possible. Skin ultrasound scans (USS), the gold standard for its detection, is too expensive for screening purposes. It is responsible for unacceptable glucose oscillations due to a high rate of hypoglycaemic episodes and rebound glucose spikes. Lipohypertrophy (LH) is a major complication of subcutaneous insulin treatment brought about by multiple overlapping injections and/or needle reuse. However, the risk of new AH development should be considered, especially in retriever breeds and dogs with allergic dermatitis. Long-term outcomes suggested that both creation of MDHs and LCI can be therapeutic options for dogs with AHs. The risk of new AHs was higher in Golden Retrievers and Labrador Retrievers and in dogs with allergic dermatitis. Sixteen of 51 (31%) dogs had multiple or new AHs. ![]() No recurrence was observed after the eighth month, and the cosmetic results were good. Recurrent AHs after LCI resolved with additional LCIs only 1 AH (2%) required a change to MDHs. The odds of recurrence increased as the numbers of LCI in the first month increased (OR, 2.414). The recurrence rate after the first month of treatment was significantly higher following the LCI procedure (17/48 AHs ) than after the MDH procedure (1/24 AHs ). ![]() Development of a new AH was defined as an AH occurring at a site different from the treated site. Recurrence was defined as development of an AH at the primary site after the first month of treatment. Medical records were reviewed, and information on signalment, clinical findings, and outcome was recorded. To investigate the outcome of surgical creation of multiple drainage holes (MDHs) versus local corticosteroid injection (LCI) for treatment of aural hematomas (AHs) in dogs and identify risk factors for recurrence and development of new AHs. These results suggest the effectiveness of corticosteroids against the hematoma reformation after aspiration, and the comparatively better prognosis after the surgery with multiple incisions using a biopsy punch. Recurrence after healing was observed in 2 of 9 cases (22.2%) receiving the corticosteroid injection, 4 of 14 cases (26.6%) treated with longitudinal incision at the hematoma site, and none of 28 cases treated with multiple incisions at the hematoma site using a biopsy punch. ![]() In 43 cases treated with surgical incision and mattress suture at the hematoma site, no recurrence was noted before the suture removal. Nine of these 23 cases received surgery after the recurrence. No cases reached healing by repeated needle aspirations alone, but 9 cases receiving repeated aspiration followed by local injection of corticosteroids reached healing within 4 weeks. All 23 cases treated with needle aspiration showed immediate recurrence of hematoma. In 2 cases untreated, 1 case, which could be followed periodically, developed marked deformation of the pinna. Various treatments and their prognosis in 59 aural hematomas of 49 dogs were evaluated retrospectively.
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