We explored the risk factors for gallbladder cancer and explanations for its sharp and constant incidence increase in Chile since the 1970s. We compared 114 consecutive patients with verified gallbladder cancer, diagnosed 1992-1995, to 114 matched hospital patients with gallstones, using conditional logistic regression analysis. Low education showed a nonsignificant positive relationship with gallbladder cancer [odds ratio (OR) ؍ 2.3, 95% confidence interval (CI) 0.8 -6.2], and low socioeconomic level showed a significant relationship (OR ؍ 5.0, 95% CI 1.5-17.3). A very long history of gallstone disease was significantly more prevalent among cases (OR ؍ 11.0, 95% CI 1.4 -85.2). Significant red chili pepper consumption was observed in gallbladder cancer patients (OR ؍ 2.9, 95% CI 1.6 -5.2). Low intake of both fresh fruit and sugar as soft drinks was associated with gallbladder cancer, with ORs of 6.4 (95% CI 1.4 -30.3) and 3.6 (95% CI 1.3-10.1), respectively. Multivariate analysis kept only a very low socioeconomic status and red chili pepper consumption as significant independent risk factors for gallbladder cancer, ORs of 6.3 (95% CI 1.7-23.0) and 3.2 (95% CI 1.7-5.9). Longstanding gallstone cases were removed from the multivariate model because all were in the low and very low socioeconomic groups, reinforcing the association. Patients with gallbladder cancer differed from matched controls by exhibiting lower socioeconomic levels, having a much longer history of gallstone disease and presenting a dietary pattern characterized by high red chili pepper consumption and low fresh fruit intake.
The anaesthetic records of 1525 dogs were examined to determine the prevalence of postanaesthetic hypothermia, its clinical predictors and consequences. Temperature was recorded throughout the anaesthesia. At the end of the procedure, details coded in were: hyperthermia (>39.50°C), normothermia (38.50°C-39.50°C), slight (38.49°C-36.50°C), moderate (36.49°C-34.00°C) and severe hypothermia (<34.00°C). Statistical analysis consisted of multiple regression to identify the factors that are associated with the temperature at the end of the procedure. Before premedication, the temperature was 38.7 ± 0.6°C (mean ± sd). At 60, 120 and 180 minutes from induction, the temperature was 36.7 ± 1.3°C, 36.1 ± 1.4°C and 35.8 ± 1.5°C, respectively. The prevalence of hypothermia was: slight, 51.5 per cent (95 per cent CI 49.0 to 54.0 per cent); moderate, 29.3 per cent (27.1-31.7 per cent) and severe: 2.8% (2.0-3.7%). The variables that associated with a decrease in the temperature recorded at the end of the anaesthesia were: duration of the preanesthetic time, duration of the anaesthesia, physical condition (ASA III and ASA IV dogs showed lower temperatures than ASA I dogs), the reason for anaesthesia (anaesthesia for diagnostic procedures or thoracic surgery reduce the temperature when compared with minor procedures), and the recumbency during the procedure (sternal and dorsal recumbencies showed lower temperatures than lateral recumbency). The temperature before premedication and the body surface (BS) were associated with a higher temperature at the end of the anaesthesia, and would be considered as protective factors.
This paper describes the cardiorespiratory variables and the incidence of anaesthetic complications in dogs. For this, a retrospective study of 1281 anaesthesias was performed. Heart rate (HR), non-invasive mean arterial (MAP), systolic (SP) and diastolic pressures (DP), invasive mean arterial (IMAP), systolic (ISP) and diastolic pressures (IDP), central venous pressure (CVP), respiratory rate (RR), tidal volume (V(T)), minute volume (V(M)), end-tidal CO(2) (EtCO(2)), arterial oxygen saturation (SpO(2)), temperature (T) and death are reported. Data were described both globally and separately for each ASA (American Society of Anaesthesiologists classification) status. An ANOVA and a Tukey's test were used for comparing the different ASA status' values (alpha=0.05). During anaesthetic maintenance, the mean +/- SD of the studied variables were: HR: 91+/-27 bpm. MAP: 86+/-24 mmHg. IMAP: 80+/-22 mmHg. SP: 114+/-25 mmHg. ISP: 109+/-26 mmHg. DP: 67+/-23 mmHg. IDP: 66+/-22 mmHg. CVP: 5+/-3 mmHg. RR: 19+/-11 rpm. V(T): 14+/-7 ml/kg. V(M): 191+/-93 ml/kg/min. EtCO(2): 40+/-8 mmHg. T: 37.1+/-1.7 degrees C. ASA III and ASA IV patients, compared with those with ASA I, showed higher values of HR, RR, V(T) and V(M) and lower in IMAP, CVP, EtCO(2), SpO(2) and T. The most frequent complications were bradycardia (36.3% of the patients), hypotension (37.9%), hypoventilation (63.4%), hypoxia (16.4%), hypothermia (4.8%) and death (0.9%). Cardiorespiratory complications frequently occur in dogs during general anaesthesia.
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