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Henshaw DS, Edwards CJ, Dobson SW, Jaffe D, Turner JD, Reynolds JW, Thompson GR, Russell G, Weller R. Evaluating residual anti-Xa levels following discontinuation of treatment-dose enoxaparin in patients presenting for elective surgery: a prospective observational trial. Reg Anesth Pain Med 2024; 49:94-101. [PMID: 37280083 DOI: 10.1136/rapm-2023-104571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/22/2023] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Prior studies have demonstrated that patients presenting for elective surgery may have higher-than-expected residual anti-Xa level activity at or beyond 24 hours following their last treatment dose of enoxaparin. Given that 24 hours of abstinence is currently recommended by both European and American societies before the performance of neuraxial or deep anesthetic/analgesic procedures, determining the actual timeframe at which residual anti-Xa level activity reliably falls below 0.2 IU/mL, the lower limit of the target range for thromboprophylaxis, is critical. METHODS This was a prospective observational trial. Consenting patients on treatment-dose enoxaparin were randomized to either a 24-hour group (last dose at 07:00 the day prior to surgery) or a 36-hour group (last dose at 19:00 2 days prior to surgery). On arrival for surgery, blood samples were obtained to assess residual anti-Xa level activity and renal function. The primary outcome was residual anti-Xa level activity following the last treatment dose of enoxaparin. Incorporating all patients, linear regression modeling was performed to predict the timepoint at which the level of anti-Xa activity reliably fell below 0.2 IU/mL. RESULTS 103 patients were analyzed. Time from the last dose at which residual anti-Xa activity fell below 0.2 IU/mL, based on the upper bound of the 95% CI, was 31.5 hours. No correlation overall between age, renal function, or sex was found. CONCLUSION Residual levels of anti-Xa activity do not reliably fall below 0.2 IU/mL 24 hours following discontinuation of treatment-dose enoxaparin. Therefore, current time-based guidelines are not conservative enough. Routine anti-Xa testing should be strongly considered, or current time-based guidelines should be reassessed. TRIAL REGISTRATION NUMBER NCT03296033.
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Affiliation(s)
- Daryl S Henshaw
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Christopher J Edwards
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sean W Dobson
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Doug Jaffe
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - James D Turner
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - J Wells Reynolds
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Garrett R Thompson
- Department of Pharmacy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Greg Russell
- Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Robert Weller
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Parikh R, Widenmaier R, Weller R, Lecrenier N. An update on national recommendations for the use of the adjuvanted recombinant zoster vaccine. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The adjuvanted recombinant zoster vaccine (RZV), first approved in 2017, has high, long-lasting efficacy against herpes zoster (HZ) and a clinically acceptable safety profile. In addition to the prevention of HZ in adults aged ≥50 years, the non-live RZV can be used from age 18 years in individuals with immunocompromised (IC) conditions. We reviewed the evolving landscape of national recommendations for RZV use.
Methods
National health authority and vaccination committee websites of countries where RZV is approved were searched in March 2022.
Results
Of 41 countries where RZV is licensed, 14 (Australia, Austria, Canada, Czech Republic, Germany, Ireland, Italy, Netherlands, New Zealand, Saudi Arabia, Spain, Switzerland, UK, US) provide national recommendations related to RZV; the majority are preferential to RZV or only recommend RZV. Overall, seven and seven countries recommend immunisation from age 50 years or 60/65 years, respectively. Of the seven countries that recommend immunisation from age 60/65 years, five recommend immunisation in individuals from age 50 years with comorbidities/IC conditions. Five countries recommend immunisation from age 18/19 years in individuals at increased risk of HZ due to immunosuppressive disease/treatment. In addition, six national recommendations refer to RZV safety and nine address prior HZ vaccination and/or infection. All recommendations outlined the RZV administration schedule.
Conclusions
Although national recommendations can inform decision making in clinical practice, RZV recommendations are not available in all licensed countries. The recommendations highlight a trend in favour of the use of RZV for the prevention of HZ in older individuals and those with IC conditions.
Main messages: An increasing number of countries are providing recommendations for the use of RZV for the prevention of HZ in older individuals and those with IC conditions.
Key messages
• An increasing number of countries are providing recommendations for the use of RZV for the prevention of HZ in older individuals.
• An increasing number of countries are providing recommendations for the use of RZV for the prevention of HZ in IC conditions.
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Affiliation(s)
- R Parikh
- Global Medical Affairs , GlaxoSmithKline, Wavre, Belgium
| | - R Widenmaier
- Global Medical Affairs , GlaxoSmithKline, Rockville, USA
| | - R Weller
- Global Medical Affairs , GlaxoSmithKline, Munich, Germany
| | - N Lecrenier
- Global Medical Affairs , GlaxoSmithKline, Wavre, Belgium
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Neuman MD, Feng R, Ellenberg SS, Sieber F, Sessler DI, Magaziner J, Elkassabany N, Schwenk ES, Dillane D, Marcantonio ER, Menio D, Ayad S, Hassan M, Stone T, Papp S, Donegan D, Marshall M, Jaffe JD, Luke C, Sharma B, Azim S, Hymes R, Chin KJ, Sheppard R, Perlman B, Sappenfield J, Hauck E, Hoeft MA, Tierney A, Gaskins LJ, Horan AD, Brown T, Dattilo J, Carson JL, Looke T, Bent S, Franco-Mora A, Hedrick P, Newbern M, Tadros R, Pealer K, Vlassakov K, Buckley C, Gavin L, Gorbatov S, Gosnell J, Steen T, Vafai A, Zeballos J, Hruslinski J, Cardenas L, Berry A, Getchell J, Quercetti N, Bajracharya G, Billow D, Bloomfield M, Cuko E, Elyaderani MK, Hampton R, Honar H, Khoshknabi D, Kim D, Krahe D, Lew MM, Maheshwer CB, Niazi A, Saha P, Salih A, de Swart RJ, Volio A, Bolkus K, DeAngelis M, Dodson G, Gerritsen J, McEniry B, Mitrev L, Kwofie MK, Belliveau A, Bonazza F, Lloyd V, Panek I, Dabiri J, Chavez C, Craig J, Davidson T, Dietrichs C, Fleetwood C, Foley M, Getto C, Hailes S, Hermes S, Hooper A, Koener G, Kohls K, Law L, Lipp A, Losey A, Nelson W, Nieto M, Rogers P, Rutman S, Scales G, Sebastian B, Stanciu T, Lobel G, Giampiccolo M, Herman D, Kaufman M, Murphy B, Pau C, Puzio T, Veselsky M, Apostle K, Boyer D, Fan BC, Lee S, Lemke M, Merchant R, Moola F, Payne K, Perey B, Viskontas D, Poler M, D'Antonio P, O'Neill G, Abdullah A, Fish-Fuhrmann J, Giska M, Fidkowski C, Guthrie ST, Hakeos W, Hayes L, Hoegler J, Nowak K, Beck J, Cuff J, Gaski G, Haaser S, Holzman M, Malekzadeh AS, Ramsey L, Schulman J, Schwartzbach C, Azefor T, Davani A, Jaberi M, Masear C, Haider SB, Chungu C, Ebrahimi A, Fikry K, Marcantonio A, Shelvan A, Sanders D, Clarke C, Lawendy A, Schwartz G, Garg M, Kim J, Caruci J, Commeh E, Cuevas R, Cuff G, Franco L, Furgiuele D, Giuca M, Allman M, Barzideh O, Cossaro J, D'Arduini A, Farhi A, Gould J, Kafel J, Patel A, Peller A, Reshef H, Safur M, Toscano F, Tedore T, Akerman M, Brumberger E, Clark S, Friedlander R, Jegarl A, Lane J, Lyden JP, Mehta N, Murrell MT, Painter N, Ricci W, Sbrollini K, Sharma R, Steel PAD, Steinkamp M, Weinberg R, Wellman DS, Nader A, Fitzgerald P, Ritz M, Bryson G, Craig A, Farhat C, Gammon B, Gofton W, Harris N, Lalonde K, Liew A, Meulenkamp B, Sonnenburg K, Wai E, Wilkin G, Troxell K, Alderfer ME, Brannen J, Cupitt C, Gerhart S, McLin R, Sheidy J, Yurick K, Chen F, Dragert K, Kiss G, Malveaux H, McCloskey D, Mellender S, Mungekar SS, Noveck H, Sagebien C, Biby L, McKelvy G, Richards A, Abola R, Ayala B, Halper D, Mavarez A, Rizwan S, Choi S, Awad I, Flynn B, Henry P, Jenkinson R, Kaustov L, Lappin E, McHardy P, Singh A, Donnelly J, Gonzalez M, Haydel C, Livelsberger J, Pazionis T, Slattery B, Vazquez-Trejo M, Baratta J, Cirullo M, Deiling B, Deschamps L, Glick M, Katz D, Krieg J, Lessin J, Mojica J, Torjman M, Jin R, Salpeter MJ, Powell M, Simmons J, Lawson P, Kukreja P, Graves S, Sturdivant A, Bryant A, Crump SJ, Verrier M, Green J, Menon M, Applegate R, Arias A, Pineiro N, Uppington J, Wolinsky P, Gunnett A, Hagen J, Harris S, Hollen K, Holloway B, Horodyski MB, Pogue T, Ramani R, Smith C, Woods A, Warrick M, Flynn K, Mongan P, Ranganath Y, Fernholz S, Ingersoll-Weng E, Marian A, Seering M, Sibenaller Z, Stout L, Wagner A, Walter A, Wong C, Orwig D, Goud M, Helker C, Mezenghie L, Montgomery B, Preston P, Schwartz JS, Weber R, Fleisher LA, Mehta S, Stephens-Shields AJ, Dinh C, Chelly JE, Goel S, Goncz W, Kawabe T, Khetarpal S, Monroe A, Shick V, Breidenstein M, Dominick T, Friend A, Mathews D, Lennertz R, Sanders R, Akere H, Balweg T, Bo A, Doro C, Goodspeed D, Lang G, Parker M, Rettammel A, Roth M, White M, Whiting P, Allen BFS, Baker T, Craven D, McEvoy M, Turnbo T, Kates S, Morgan M, Willoughby T, Weigel W, Auyong D, Fox E, Welsh T, Cusson B, Dobson S, Edwards C, Harris L, Henshaw D, Johnson K, McKinney G, Miller S, Reynolds J, Segal BS, Turner J, VanEenenaam D, Weller R, Lei J, Treggiari M, Akhtar S, Blessing M, Johnson C, Kampp M, Kunze K, O'Connor M, Looke T, Tadros R, Vlassakov K, Cardenas L, Bolkus K, Mitrev L, Kwofie MK, Dabiri J, Lobel G, Poler M, Giska M, Sanders D, Schwartz G, Giuca M, Tedore T, Nader A, Bryson G, Troxell K, Kiss G, Choi S, Powell M, Applegate R, Warrick M, Ranganath Y, Chelly JE, Lennertz R, Sanders R, Allen BFS, Kates S, Weigel W, Li J, Wijeysundera DN, Kheterpal S, Moore RH, Smith AK, Tosi LL, Looke T, Mehta S, Fleisher L, Hruslinski J, Ramsey L, Langlois C, Mezenghie L, Montgomery B, Oduwole S, Rose T. Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial. Ann Intern Med 2022; 175:952-960. [PMID: 35696684 DOI: 10.7326/m22-0320] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) trial found similar ambulation and survival at 60 days with spinal versus general anesthesia for hip fracture surgery. Trial outcomes evaluating pain, prescription analgesic use, and patient satisfaction have not yet been reported. OBJECTIVE To compare pain, analgesic use, and satisfaction after hip fracture surgery with spinal versus general anesthesia. DESIGN Preplanned secondary analysis of a pragmatic randomized trial. (ClinicalTrials.gov: NCT02507505). SETTING 46 U.S. and Canadian hospitals. PARTICIPANTS Patients aged 50 years or older undergoing hip fracture surgery. INTERVENTION Spinal or general anesthesia. MEASUREMENTS Pain on postoperative days 1 through 3; 60-, 180-, and 365-day pain and prescription analgesic use; and satisfaction with care. RESULTS A total of 1600 patients were enrolled. The average age was 78 years, and 77% were women. A total of 73.5% (1050 of 1428) of patients reported severe pain during the first 24 hours after surgery. Worst pain over the first 24 hours after surgery was greater with spinal anesthesia (rated from 0 [no pain] to 10 [worst pain imaginable]; mean difference, 0.40 [95% CI, 0.12 to 0.68]). Pain did not differ across groups at other time points. Prescription analgesic use at 60 days occurred in 25% (141 of 563) and 18.8% (108 of 574) of patients assigned to spinal and general anesthesia, respectively (relative risk, 1.33 [CI, 1.06 to 1.65]). Satisfaction was similar across groups. LIMITATION Missing outcome data and multiple outcomes assessed. CONCLUSION Severe pain is common after hip fracture. Spinal anesthesia was associated with more pain in the first 24 hours after surgery and more prescription analgesic use at 60 days compared with general anesthesia. PRIMARY FUNDING SOURCE Patient-Centered Outcomes Research Institute.
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Affiliation(s)
- Mark D Neuman
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, and Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (M.D.N., N.E., L.J.G.)
| | - Rui Feng
- Department of Biostatistics, Epidemiology, and Informatics, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (R.F., S.S.E.)
| | - Susan S Ellenberg
- Department of Biostatistics, Epidemiology, and Informatics, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (R.F., S.S.E.)
| | - Frederick Sieber
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland (F.S.)
| | - Daniel I Sessler
- Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio (D.I.S., S. Ayad, M.H.)
| | - Jay Magaziner
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland (J.M.)
| | - Nabil Elkassabany
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, and Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (M.D.N., N.E., L.J.G.)
| | - Eric S Schwenk
- Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (E.S.S.)
| | - Derek Dillane
- Department of Anesthesiology and Pain Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada (D. Dillane)
| | - Edward R Marcantonio
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts (E.R.M.)
| | - Diane Menio
- Center for Advocacy for the Rights and Interests of the Elderly, Philadelphia, Pennsylvania (D.M.)
| | - Sabry Ayad
- Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio (D.I.S., S. Ayad, M.H.)
| | - Manal Hassan
- Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio (D.I.S., S. Ayad, M.H.)
| | - Trevor Stone
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada (T.S.)
| | - Steven Papp
- Division of Orthopaedics, Ottawa Hospital Civic Campus, Ottawa, Ontario, Canada (S.P.)
| | - Derek Donegan
- Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (D. Donegan)
| | - Mitchell Marshall
- Department of Anesthesiology, New York University Langone Medical Center, New York, New York (M.M.)
| | - J Douglas Jaffe
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina (J.D.J.)
| | - Charles Luke
- Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (C.L.)
| | - Balram Sharma
- Department of Anesthesiology, Lahey Hospital and Medical Center, Burlington, Massachusetts (B.S.)
| | - Syed Azim
- Department of Anesthesiology, Stony Brook University, Stony Brook, New York (S. Azim)
| | - Robert Hymes
- Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia (R.H.)
| | - Ki-Jinn Chin
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada (K.C.)
| | - Richard Sheppard
- Department of Anesthesiology, Hartford Hospital, Hartford, Connecticut (R.S.)
| | - Barry Perlman
- Oregon Health and Science University, Portland, Oregon (B.P.)
| | - Joshua Sappenfield
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida (J.S.)
| | - Ellen Hauck
- Department of Anesthesiology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania (E.H.)
| | - Mark A Hoeft
- Department of Anesthesiology, University of Vermont Larner College of Medicine, Burlington, Vermont (M.A.H.)
| | - Ann Tierney
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (A.T., T.B., J.D.)
| | - Lakisha J Gaskins
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, and Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (M.D.N., N.E., L.J.G.)
| | - Annamarie D Horan
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, and Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (A.D.H.)
| | - Trina Brown
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (A.T., T.B., J.D.)
| | - James Dattilo
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (A.T., T.B., J.D.)
| | - Jeffrey L Carson
- Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey (J.L.C.)
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Turner JD, Cortese KT, Kim ST, McKee ZL, Jaffe D, Henshaw DS, Dobson SW, Weller R, Edwards CJ, Reynolds JW, Russell G. Mean plasma bupivacaine concentrations following pectoral nerve blocks (PECS II). Reg Anesth Pain Med 2021; 47:194-195. [PMID: 34610964 DOI: 10.1136/rapm-2021-102984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/10/2021] [Indexed: 11/03/2022]
Affiliation(s)
- James D Turner
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Kevin T Cortese
- Internal Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Seiha T Kim
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Zachary L McKee
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Doug Jaffe
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Daryl S Henshaw
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sean W Dobson
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Robert Weller
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Christopher J Edwards
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - J Wells Reynolds
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Greg Russell
- Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
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Shikur F, Yeung H, Amogne W, Weller R. Pattern of skin disease in Ethiopian HIV-infected patients on combination antiretroviral therapy: A cross-sectional study in a dermatology referral hospital. Skin Health Dis 2021; 1:e28. [PMID: 35664986 PMCID: PMC9060129 DOI: 10.1002/ski2.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 11/16/2022]
Abstract
Background More than 90% of human immunodeficiency virus (HIV)-infected patients will develop at least one type of skin disorder during the course of the disease. The prevalence and severity of skin disease commonly seen in HIV-infected patients has decreased in the era of combination antiretroviral therapy (cART). Few studies in Ethiopia have shown the magnitude of skin problems among adult patients on cART. The aim of this study is to describe the pattern of skin disease among adult patients who are on cART. Methods Cross-sectional observational study at ALERT Hospital from April 2018 to November 2018. Patterns of clinically diagnosed skin diseases were summarized descriptively. Result A total of 572 patients were evaluated. In total, 412 (72%) were female and the mean age of study participants was 40 (SD = 10.4). The median CD4 count at the time of diagnosis and start of cART were 178 (R 5-2000) and 168 cells/μl (R 5-1327), respectively. The mean duration of cART was 8 (SD = 3) years. 89.3% of patients were on first line and 7% on second line of cART regimen. Noninfectious inflammatory skin disorders (40.9%) were the most common concomitant diagnosis followed by infectious diseases (34.9%), infestation (7.7%), pigmentary disorders (6.3%) and cutaneous drug eruption (0.7%), respectively. Among the inflammatory skin disorders, 56.5% presented with eczema. One patient had Kaposi sarcoma. Conclusion Noninfectious inflammatory skin disorders are the most common concomitant skin disease in HIV-infected patients, with eczema being most prevalent. Infectious skin diseases were also common presentations. In our study, AIDS-defining skin conditions were rare.
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Affiliation(s)
- F. Shikur
- Department of DermatovenereologySchool of Medicine, Addis Ababa UniversityAddis AbabaEthiopia
| | - H. Yeung
- Department of DermatologyEmory University School of MedicineAtlantaGeorgiaUSA
| | - W. Amogne
- Department of Internal MedicineSchool of Medicine, Addis Ababa UniversityAddis AbabaEthiopia
| | - R. Weller
- Division of Medical and Radiological SciencesUniversity of EdinburghEdinburghUK
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Zhang Y, Sevilla A, Weller R, Wang S, Gitlin MC, Candiotti KA. The role of α7-nicotinic acetylcholine receptor in a rat model of chronic nicotine-induced mechanical hypersensitivity. Neurosci Lett 2020; 743:135566. [PMID: 33352289 DOI: 10.1016/j.neulet.2020.135566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 12/19/2022]
Abstract
Smokers have a higher incidence of chronic pain than non-smokers, but the neural mechanism is not yet fully understood. Nicotine is the main component of tobacco and acts as an agonist for nicotinic cholinergic receptors (nAChRs) in the nervous system. This study was approved by the IACUC of UM. The effects of chronic nicotine administration on mechanical sensitivity were studied using a rat model. The changes in the expression levels of the α7 isoform of nAChR (α7-nAChR), inflammatory cytokines TNFα and COX-2, as well as the density of neuro-immune cells (astrocytes and microglia) were measured concurrently. The results indicate that long-term nicotine administration induces hypersensitivity to mechanical stimuli, as demonstrated by a significant reduction in the pain perception threshold. In response to nicotine, the expression levels of α7-nAChR increased in the periaqueductal gray matter (PAG) and decreased in the spinal cord. Acute administration of the selective α7-nAChR agonist CDP-Choline reversed this hypersensitivity. Chronic nicotine administration led to an increase of microglial cells in the dorsal horn of the spinal cord and increased expression levels of the cytokines TNFα and COX-2. This study suggests that decreased α7-nAChR expression in the spinal cord, as a result of long-term exposure to nicotine, may be causatively linked to chronic pain. Simultaneously, the increase of neuro-immune factors in the spinal cord is also a potential factor leading to chronic pain.
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Affiliation(s)
- Yanping Zhang
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA.
| | - Alec Sevilla
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA
| | - Robert Weller
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA
| | - Shuju Wang
- Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Melvin C Gitlin
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA
| | - Keith A Candiotti
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA.
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Markosyan T, Sargsyan K, Kharatyan S, Elbakyan H, Hakobyan V, Simonyan L, Voskanyan H, Shirvanyan A, Stepanyan T, Khachatryan M, Karapetyan M, Avagyan A, Mcvey WR, Weller R, Keen J, Risatti GR. The epidemiological status of African swine fever in domestic swine herds in the Tavush Province region, Armenia. REV SCI TECH OIE 2020; 38:751-760. [PMID: 32286569 DOI: 10.20506/rst.38.3.3024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
KEEN The factors associated with the spread and persistence of African swine fever (ASF) in the Caucasus region remain to be fully identified. It is assumed that large naive populations of domestic free-ranging and wild pigs are critical to disease transmission and maintenance. Nonetheless, 11 years since its epidemic introduction into the region in 2007, ASF virus (ASFV) is still circulating, suggesting that an endemic cycle has been established based on contact between free-ranging domestic pigs and wild pigs, and that native Ornithodoros ticks probably serve as reservoirs for the virus. Therefore, research is required to gather information on the epidemiological status of ASF in the Caucasus region, focusing particularly on understanding modes of ASFV spread and persistence in this new virus environment. The authors established an ASFV survey targeting domestic pigs in the Tavush province of northern Armenia, an area of the country considered to be at high risk of disease incursion/occurrence. All tested samples collected for this survey were negative for ASF. The probability of observing no reactors by antibody enzyme-linked immunosorbent assay in a sample of this size (n = 1,506) from a population with an estimated disease prevalence of 1% is very low (< 0.0001). Therefore, it is possible but very unlikely for ASFV to be present among domestic pigs in the Tavush province region.
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Zhang Y, Yang J, Sevilla A, Weller R, Wu J, Su C, Zheng C, Rodriguez-Blanco YF, Gitlin M, Candiotti KA. The mechanism of chronic nicotine exposure and nicotine withdrawal on pain perception in an animal model. Neurosci Lett 2020; 715:134627. [DOI: 10.1016/j.neulet.2019.134627] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 01/17/2023]
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Maisonpierre IN, Sutton MA, Harris P, Menzies-Gow N, Weller R, Pfau T. Accelerometer activity tracking in horses and the effect of pasture management on time budget. Equine Vet J 2019; 51:840-845. [PMID: 31009100 DOI: 10.1111/evj.13130] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/11/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Accelerometry is an accepted means of quantifying human physical activity. Quantitative physical activity tracking could be beneficial for studies into equine health and disease prevention, for example in relation to obesity management. OBJECTIVES Validate accelerometer use in grazing horses, determine between-day repeatability, and assess the effects of pasture size on time budget (i.e. duration in each activity category). STUDY DESIGN Proof of concept. METHODS Accelerometers (ActiGraph) were positioned at the poll. Horses underwent 5 min of observed activity in three categories: standing, grazing and ambulating. Receiver-operating characteristic curve analysis, used on ten second data epochs, calculated cut points between the activities. A 20-day study was then undertaken on 6 horses at pasture. Time in each category (per day) was deduced; a Mann Whitney U test was performed to compare standard vs. small paddock and day vs. night turn out. RESULTS Cut-off values with the optimum sensitivity (94.7-97.7%) and specificity (94.7-96.8%) were found to be <127.6 counts for standing, 127.6-702.7 counts for grazing and >702.7 counts for ambulating. Repeatability was analysed descriptively: Median (IQR) of the between-day difference in minutes standing, grazing and ambulating were 46.9 (21.3-87.9), 77.3 (40.2-124.5) and 15.6 (6.8-40.2) respectively. Median times standing and ambulating were significantly different between standard and small paddocks: standing: 8.7 vs. 10.3 h (P<0.001); ambulating: 55.7 vs. 39.6 min (P = 0.002). There was no significant difference in the median time spent grazing. There were significant differences between day and night: standing: 32.95% vs. 50.97% (P = 0.001), grazing: 60.81% vs. 46.77% (P<0.001) and ambulating: 4.57% vs. 2.40% (P<0.001). MAIN LIMITATIONS Small sample size and lack of cross-validation of cut-off points on independent, 'unseen' data. CONCLUSIONS Accelerometry can differentiate standing, grazing and ambulating in horses. Our proof-of-concept study demonstrates modifying pasture size influences activity budgets; opening avenues into studying obesity management.
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Affiliation(s)
- I N Maisonpierre
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - M A Sutton
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - P Harris
- Mars Horsecare UK Ltd, Equine Studies Group, Waltham Centre for Pet Nutrition, Bury St Edmunds, UK
| | - N Menzies-Gow
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - R Weller
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - T Pfau
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
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Manso‐Díaz G, Taeymans O, García‐López JM, Weller R. Application and indications of magnetic resonance imaging and computed tomography of the equine head. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- G. Manso‐Díaz
- Hospital Clínico Veterinario Complutense Universidad Complutense de Madrid Madrid Spain
- The Royal Veterinary College Hatfield Hertfordshire UK
| | | | - J. M. García‐López
- Department of Clinical Sciences Cummings School of Veterinary Medicine Tufts University North Grafton Massachusetts USA
| | - R. Weller
- The Royal Veterinary College Hatfield Hertfordshire UK
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Vepkhvadze NG, Menteshashvili I, Kokhreidze M, Goginashvili K, Tigilauri T, Mamisashvili E, Gelashvili L, Abramishvili T, Donduashvili M, Ghvinjilia G, Avaliani L, Parkadze O, Ninidze L, Kartskhia N, Napetvaridze T, Rukhadze Z, Asanishvili Z, Weller R, Risatti GR. Active surveillance of African swine fever in domestic swine herds in Georgia, 2014. REV SCI TECH OIE 2018; 36:879-887. [PMID: 30160694 DOI: 10.20506/rst.36.3.2721] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Since its introduction to the Republic of Georgia in 2007, African swine fever virus (ASFV) has spread across the Caucasus region, the Russian Federation, and some Eastern European countries. It is assumed that large populations of naïve, domestic, free-ranging and wild pigs are vital to the transmission of the disease. Since its epidemic emergence in the region in 2007, ASFV has continued to circulate, which suggests that an endemic cycle has been established and is maintained by contact between free-ranging domestic pigs, wild pigs, and possibly native Ornithodoros ticks, the most likely reservoirs for the virus. In 2014, a survey was conducted across the Republic of Georgia to determine ASFV prevalence among domestic swine herds. All 1,231 samples collected for this survey tested negative for ASF. The probability of observing no reactors in a sample of this size (n = 1,231) from a population with an estimated disease prevalence of 1% is very low (<0.0001). Therefore, it is possible but very unlikely that ASFV was present among domestic swine during the span of this survey. These data suggest that, in 2014, domestic pig herds were not the source of the virus, and that the ASF endemic cycle may be supported by the circulation of ASFV among feral pigs, wild pigs, and possibly native Ornithodoros ticks.
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Manso-Diaz G, Weller R, Biggi M. Clinical insights: Advances in diagnostic imaging: Fractures. Equine Vet J 2018; 50:708-709. [PMID: 30265411 DOI: 10.1111/evj.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G Manso-Diaz
- Universidad Complutense de Madrid, Madrid, Spain
| | - R Weller
- Royal Veterinary College, North Mymms, Hatfield, Hertfordshire, UK
| | - M Biggi
- Royal Veterinary College, North Mymms, Hatfield, Hertfordshire, UK
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13
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Affiliation(s)
- R Weller
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - A Barstow
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - H Price
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - T Pfau
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK
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14
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Bryant HA, Dixon JJ, Weller R, Bolt DM. Use of positive contrast radiography to identify synovial involvement in horses with traumatic limb wounds. Equine Vet J 2018; 51:20-23. [PMID: 29931725 DOI: 10.1111/evj.12985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/18/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND The diagnostic value of positive contrast radiography in the work-up of suspected synovial infection in horses with limb wounds near synovial structures has yet to be systematically evaluated. OBJECTIVES To determine the specificity, sensitivity and positive and negative predictive values of positive contrast radiography for identification of synovial infection in a population of horses with limb wounds. STUDY DESIGN Retrospective case study comparing the performance of positive contrast radiography to the gold standard of synovial fluid cytology in horses presenting with limb wounds in the vicinity of synovial structures. METHODS Case records of horses presenting to the Royal Veterinary College Equine Hospital between 2010 and 2015 with limb wounds that may have compromised adjacent synovial structures were analysed. Synovial fluid cytology results were used to categorise synovial structures in infected and noninfected groups. Positive contrast radiography results were compared between infected and noninfected groups and sensitivity, specificity, positive and negative predictive values were calculated. RESULTS Fifty horses with 66 synovial structures were included in the study. Positive contrast radiography had a high specificity (86.4%), but only a moderate sensitivity (59.1%) for the identification of synovial infection. In addition, a low positive predictive value (68.4%) and high negative predictive value (80.9%) were observed in this population of horses. MAIN LIMITATIONS Sensitivity, specificity and predictive values may differ between different synovial structures and cases. Different conclusions may be drawn from the results in a single population. Sensitivity and specificity of positive contrast radiography may also be influenced by different techniques used by examiners and by inherent characteristics of individual cases. CONCLUSIONS Positive contrast radiography should be used for the investigation of potential synovial infection in horses with limb wounds, particularly if no synovial fluid sample for laboratory analysis can be obtained. However, it appears that positive contrast radiography is best used in combination with other tests to ensure that a correct and timely diagnosis is made.
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Affiliation(s)
- H A Bryant
- Department of Clinical Science & Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - J J Dixon
- Rainbow Equine Hospital, Malton, North Yorkshire, UK
| | - R Weller
- Department of Clinical Science & Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - D M Bolt
- Department of Clinical Science & Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
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15
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Barstow A, Bailey J, Campbell J, Harris C, Weller R, Pfau T. Does 'hacking' surface type affect equine forelimb foot placement, movement symmetry or hoof impact deceleration during ridden walk and trot exercise? Equine Vet J 2018; 51:108-114. [PMID: 29665054 DOI: 10.1111/evj.12952] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 03/31/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Both pleasure and competition horses regularly exercise on surfaces such as tarmac, gravel and turf during 'hacking'. Despite this, there is limited evidence relating to the effect of these surfaces upon foot-surface interaction. OBJECTIVES To investigate forelimb foot placement, hoof vibration and movement symmetry in pleasure horses on three commonly encountered hacking surfaces. STUDY DESIGN Quantitative gait study in a convenience sample. METHODS Six horses regularly partaking in hacking exercise were ridden in walk and trot on all surfaces. Horses were equipped with one hoof-mounted, accelerometer and four body-mounted inertial measurement units (IMUs) to measure foot impact and movement symmetry. High-speed (400 FPS) video footage of foot-placement was acquired (dorsal, palmar, lateral views). Foot-impact and movement symmetry were analysed with a mixed effects model and Bowker symmetry tests for foot-placement analysis. RESULTS Vibration power and frequency parameters increase as perceived surface firmness increases from grass, to gravel, to tarmac (P≤0.001). Vibration power parameters were consistently greater at trot compared with walk (P≤0.001), but the same was not true for vibration frequency (P≥0.2). Greatest movement asymmetry was recorded during grass surface trotting. No significant difference in foot-placement was detected between the three surfaces. MAIN LIMITATIONS This was a field study using three commonly encountered hacking surfaces. Surface properties change easily with water content and temperature fluctuations so care must be taken when considering other similar surfaces, especially at different times of the year. Six leisure horses were used so the results may not be representative of horses of all types. CONCLUSIONS Vibration parameters generally increase as perceived surface firmness increases. Increasing speed alters vibration power but not frequency. Further investigations are required to determine the role that this may play in the development of musculoskeletal disease in horses.
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Affiliation(s)
- A Barstow
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.,Structure and Motion Laboratory, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - J Bailey
- Structure and Motion Laboratory, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - J Campbell
- Structure and Motion Laboratory, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - C Harris
- Structure and Motion Laboratory, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - R Weller
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.,Structure and Motion Laboratory, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - T Pfau
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.,Structure and Motion Laboratory, Royal Veterinary College, Hatfield, Hertfordshire, UK
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16
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Crijns CP, Weller R, Vlaminck L, Verschooten F, Schauvliege S, Powell SE, Bree HJJ, Gielen IMVL. Comparison between radiography and computed tomography for diagnosis of equine skull fractures. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12863] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - R. Weller
- Veterinary Clinical Sciences Royal Veterinary College Hatfield Hertfordshire UK
| | - L. Vlaminck
- Department of Surgery and Anaesthesia of Domestic Animals Faculty of Veterinary Medicine, Ghent University Merelbeke Belgium
| | - F. Verschooten
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - S. Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals Faculty of Veterinary Medicine, Ghent University Merelbeke Belgium
| | | | - H. J. J. Bree
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - I. M. V. L. Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
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Pfau T, Simons V, Rombach N, Stubbs N, Weller R. Effect of a 4-week elastic resistance band training regimen on back kinematics in horses trotting in-hand and on the lunge. Equine Vet J 2017; 49:829-835. [DOI: 10.1111/evj.12690] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 04/16/2017] [Indexed: 11/30/2022]
Affiliation(s)
- T. Pfau
- Department of Clinical Science and Services; Royal Veterinary College; London UK
- Structure and Motion Lab; Royal Veterinary College; London UK
| | - V. Simons
- Department of Clinical Science and Services; Royal Veterinary College; London UK
| | | | - N. Stubbs
- Department of Equine Sports Medicine; Tierklinik Lüsche; Germany and Samorin, Napoli Slovak Equestrian Club Ślovak
| | - R. Weller
- Department of Clinical Science and Services; Royal Veterinary College; London UK
- Structure and Motion Lab; Royal Veterinary College; London UK
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Dixon J, Lam R, Weller R, Manso-Díaz G, Smith M, Piercy RJ. Clinical application of multidetector computed tomography and magnetic resonance imaging for evaluation of cranial nerves in horses in comparison with high resolution imaging standards. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12629] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- J. Dixon
- Department of Clinical Sciences and Services; Royal Veterinary College; Hatfield UK
| | - R. Lam
- Department of Clinical Sciences and Services; Royal Veterinary College; Hatfield UK
| | - R. Weller
- Department of Clinical Sciences and Services; Royal Veterinary College; Hatfield UK
| | - G. Manso-Díaz
- Department of Animal Medicine and Surgery; School of Veterinary Medicine; Universidad Complutense de Madrid; Spain
| | - M. Smith
- Department of Clinical Sciences and Services; Royal Veterinary College; Hatfield UK
| | - R. J. Piercy
- Department of Clinical Sciences and Services; Royal Veterinary College; Hatfield UK
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Moura da Costa Barcelos K, Souza Carneiro de Rezende A, Weller R, Quintão Lana A, Resende Faleiros R. Closure times of the physes in high performance Mangalarga Marchador gaited horses - preliminary findings. J Vet Behav 2016. [DOI: 10.1016/j.jveb.2016.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pfau T, Daly K, Davison J, Bould A, Housby N, Weller R. Changes in movement symmetry over the stages of the shoeing process in military working horses. Vet Rec 2016; 179:195. [DOI: 10.1136/vr.103516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2016] [Indexed: 11/04/2022]
Affiliation(s)
- T. Pfau
- Department of Clinical Science and Services; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Herts AL9 7TA UK
| | - K. Daly
- Department of Clinical Science and Services; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Herts AL9 7TA UK
| | - J. Davison
- Department of Clinical Science and Services; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Herts AL9 7TA UK
| | - A. Bould
- The King's Troop, Royal Horse Artillery; Woolwich London UK
| | - N. Housby
- The King's Troop, Royal Horse Artillery; Woolwich London UK
| | - R. Weller
- Department of Clinical Science and Services; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Herts AL9 7TA UK
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Affiliation(s)
- J. Dixon
- Royal Veterinary College; Equine Referral Hospital; Hatfield Hertfordshire UK
| | - M. Biggi
- Royal Veterinary College; Equine Referral Hospital; Hatfield Hertfordshire UK
| | - R. Weller
- Royal Veterinary College; Equine Referral Hospital; Hatfield Hertfordshire UK
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Whitlock J, Dixon J, Sherlock C, Tucker R, Bolt DM, Weller R. Technical innovation changes standard radiographic protocols in veterinary medicine: is it necessary to obtain two dorsoproximal-palmarodistal oblique views of the equine foot when using computerised radiography systems? Vet Rec 2016; 178:531. [PMID: 27114406 DOI: 10.1136/vr.103396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 11/04/2022]
Abstract
Since the 1950s, veterinary practitioners have included two separate dorsoproximal-palmarodistal oblique (DPr-PaDiO) radiographs as part of a standard series of the equine foot. One image is obtained to visualise the distal phalanx and the other to visualise the navicular bone. However, rapid development of computed radiography and digital radiography and their post-processing capabilities could mean that this practice is no longer required. The aim of this study was to determine differences in perceived image quality between DPr-PaDiO radiographs that were acquired with a computerised radiography system with exposures, centring and collimation recommended for the navicular bone versus images acquired for the distal phalanx but were subsequently manipulated post-acquisition to highlight the navicular bone. Thirty images were presented to four clinicians for quality assessment and graded using a 1-3 scale (1=textbook quality, 2=diagnostic quality, 3=non-diagnostic image). No significant difference in diagnostic quality was found between the original navicular bone images and the manipulated distal phalanx images. This finding suggests that a single DPr-PaDiO image of the distal phalanx is sufficient for an equine foot radiographic series, with appropriate post-processing and manipulation. This change in protocol will result in reduced radiographic study time and decreased patient/personnel radiation exposure.
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Affiliation(s)
- J Whitlock
- Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - J Dixon
- Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - C Sherlock
- Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - R Tucker
- Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - D M Bolt
- Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - R Weller
- Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
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Pfau T, Weller R. Comparison of a standalone consumer grade smartphone with a specialist inertial measurement unit for quantification of movement symmetry in the trotting horse. Equine Vet J 2015; 49:124-129. [PMID: 26518143 DOI: 10.1111/evj.12529] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/17/2015] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY Equine inertial measurement unit (IMU) gait analysis has gained in popularity for use in horses. Similar transducers are now found in consumer grade smartphones. However, to date there are no scientific data evaluating their use for assessment of movement (a)symmetry in the horse. OBJECTIVES To establish limits of agreement (LoA, mean difference ±2 s.d.) between a validated specialist IMU system and IMU data collected with a consumer grade smartphone for quantification of movement symmetry and range of motion (ROM) of pelvic movement in the trotting horse. STUDY DESIGN Method comparison study based on quantitative gait data. METHODS Twenty horses were equipped with a specialist IMU (MTw, Xsens) and a consumer grade smartphone (Apple iPhone6), both securely attached immediately in front of one another in the midline over the sacrum. Horses were trotted in-hand and lunged on both reins on a soft arena surface. Median values for movement symmetry and ROM were determined over a series of strides for each exercise condition. Data collection was repeated in 6 horses to determine the effect of mediolateral sensor positioning on outcome parameters. RESULTS Valid data from 17 horses resulted in LoA values of -3.7 ± 9.2 mm for MinDiff (difference between left and right hind mid stance), -0.6 ± 6.0 mm for MaxDiff (difference between left and right hind propulsion) and -0.8 ± 7.4 mm for ROM across horses and exercises. LoAs were narrower for straight line exercise and the negative bias was considerably reduced when moving the smartphone to the right of the midline. CONCLUSIONS The consumer grade smartphone provided meaningful gait data in horses: LoAs in particular for in-hand exercise and when adjusting the mediolateral positioning are similar to published asymmetry thresholds. Owing to the sensitivity to mediolateral positioning, particular care should be taken when placing an IMU over the midline of the horse.
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Affiliation(s)
- T Pfau
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - R Weller
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
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Simons V, Weller R, Stubbs NC, Rombach N, Pfau T. Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015. Equine Vet J 2015; 47 Suppl 48:11. [PMID: 26375722 DOI: 10.1111/evj.12486_23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
REASONS FOR PERFORMING STUDY Training and rehabilitation techniques which improve core muscle strength are beneficial for improvement of dynamic stability of the equine vertebral column. The Equiband™ system, consisting of resistance bands attached to a customised saddle pad, is suggested to provide constant proprioceptive feedback during motion to encourage recruitment of abdominal and hindquarter musculature. OBJECTIVES To quantify the effect of the Equiband™ system on back kinematics and movement symmetry. STUDY DESIGN Longitudinal intervention study. METHODS Quantitative analysis of back movement and gait symmetry before/after a 4-week exercise programme. Inertial sensor data was collected from 7 horses at Weeks 0 and 4 of a fixed exercise protocol. Analysis with and without the Equiband™ system was completed at trot in hand on a hard surface, and for both reins on the lunge on a soft surface. Six back kinematic and 3 movement symmetry parameters were calculated according to published methods. Movement symmetry values were side-corrected to allow comparison between reins on the lunge. A mixed model (P<0.05) evaluated the effects of the Equiband™ system over time, and trotting direction on back kinematic and movement symmetry parameters. RESULTS The Equiband™ system significantly reduced (all P<0.02) roll, pitch and mediolateral displacement in the cranial-mid thoracic region. Across all horses, back displacement and range of motion values were significantly greater (P<0.01) on the lunge than in a straight line, movement symmetry was consistent with having corrected all horses to be left-sided. CONCLUSION Preliminary results suggest the Equiband™ system may aid dynamic stabilisation of the vertebral column. Ethical animal research: This study was authorised by the Ethics and Welfare Committee of the Royal Veterinary College, London (URN Approval Number 1238). Written consent was obtained from the owner/keeper of each animal. SOURCE OF FUNDING Royal Veterinary College. Competing interests: N.C. Stubbs and N. Rombach developed the Equiband™ system. The remaining authors have no competing interests.
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Affiliation(s)
- V Simons
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hatfield, AL9 7TA, UK
| | - R Weller
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hatfield, AL9 7TA, UK
| | | | | | - T Pfau
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hatfield, AL9 7TA, UK
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Satchell G, McGrath M, Dixon J, Pfau T, Weller R. Effects of Time of Day, Ambient Temperature and Relative Humidity on the Repeatability of Infrared Thermographic Imaging in Horses. Equine Vet J 2015; 47 Suppl 48:13-4. [DOI: 10.1111/evj.12486_30] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G. Satchell
- Department of Clinical Science and Services; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - M. McGrath
- Department of Clinical Science and Services; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - J. Dixon
- Department of Clinical Science and Services; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - T. Pfau
- Department of Clinical Science and Services; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - R. Weller
- Department of Clinical Science and Services; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
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Ault B, Starling G, Parkes R, Pfau T, Pardoe C, Day P, Bettison C, Weller R. The Effect of Three Different Shoeing Conditions on Tendon Strain in the Thoroughbred Forelimb. Equine Vet J 2015. [DOI: 10.1111/evj.12486_39] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- B. Ault
- Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - G. Starling
- Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - R. Parkes
- Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - T. Pfau
- Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - C. Pardoe
- Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - P. Day
- Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - C. Bettison
- Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - R. Weller
- Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
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Parkes R, Witte T, Pfau T, Weller R. An In VitroInvestigation of the Effect of Curve Running on Equine Distal Limb Tendon Strain. Equine Vet J 2015. [DOI: 10.1111/evj.12486_25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R.S.V. Parkes
- Structure and Motion Laboratory; Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - T.H. Witte
- Structure and Motion Laboratory; Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - T. Pfau
- Structure and Motion Laboratory; Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - R. Weller
- Structure and Motion Laboratory; Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
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Wilson A, Agass R, Vaux S, Sherlock E, Day P, Pfau T, Weller R. Foot placement of the equine forelimb: Relationship between foot conformation, foot placement and movement asymmetry. Equine Vet J 2014; 48:90-6. [PMID: 25523459 DOI: 10.1111/evj.12378] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/30/2014] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY Hoof conformation, foot placement and movement asymmetry are routinely assessed as part of the lameness examination. However, to date, few studies have described these parameters, or the interplay between them, in the general horse population. OBJECTIVES To assess foot conformation and foot placement in the forelimbs of a group of general purpose horses and investigate the relationships between foot placement, foot conformation and movement asymmetry. STUDY DESIGN Observational cross-sectional study. METHODS Forty-three horses were included in the study. Measurements were taken from photographs of each forelimb to assess foot conformation. Video footage was recorded simultaneously from perpendicular cameras at both walk and trot and used to categorise foot placement. Inertial sensor data were used to assess head movement asymmetry in trot. RESULTS There was a high degree of variation in foot placement between and within horses, but a 'lateral heel' placement was most common in walk and a 'lateral' placement most common in trot. Foot placement was associated with dorsal and palmar hoof angles but there was no relationship between foot placement and the other conformation parameters, nor with movement asymmetry. Moderate negative correlations were found between several of the conformation parameters and movement asymmetry. CONCLUSIONS A relationship exists between foot conformation and movement asymmetry with decreasing hoof width and hoof length related to increasing amount of movement asymmetry. In the population of horses studied here--deemed to be 'well functioning' by their owners/riders--foot placement was found to be independent of movement asymmetry and, to a large extent, independent of foot conformation.
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Affiliation(s)
- A Wilson
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - R Agass
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - S Vaux
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - E Sherlock
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - P Day
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - T Pfau
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - R Weller
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
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Pfau T, Jennings C, Mitchell H, Olsen E, Walker A, Egenvall A, Tröster S, Weller R, Rhodin M. Lungeing on hard and soft surfaces: Movement symmetry of trotting horses considered sound by their owners. Equine Vet J 2014; 48:83-9. [PMID: 25297461 DOI: 10.1111/evj.12374] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 09/30/2014] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY Lungeing is often part of the clinical lameness examination. The difference in movement symmetry, which is a commonly employed lameness measure, has not been quantified between surfaces. OBJECTIVES To compare head and pelvic movement symmetry between surfaces and reins during lungeing. STUDY DESIGN Quantitative gait analysis in 23 horses considered sound by their owners. METHODS Twenty-three horses were assessed in-hand and on the lunge on both reins on hard and soft surfaces with inertial sensors. Seven movement symmetry parameters were quantified and used to establish 2 groups, namely symmetrical (n = 9) and forelimb-lame horses (n = 14), based on values from straight-line assessment. Movement symmetry values for left rein measurements were side corrected to allow comparison of the amount of movement symmetry between reins. A mixed model (P<0.05) was used to study effects on movement symmetry of surface (hard/soft) and rein (inside/outside with respect to movement symmetry on the straight). RESULTS In forelimb-lame horses, surface and rein were identified as significantly affecting all head movement symmetry measures (rein, all P<0.0001; surface, all P<0.042). In the symmetrical group, no significant influence of surface or rein was identified for head movement symmetry (rein, all P>0.245; surface, all P>0.073). No significant influence of surface or rein was identified for any of the pelvic movement symmetry measures in either group. CONCLUSIONS While more symmetrical horses showed a consistent amount of movement symmetry across surfaces/reins, horses objectively quantified as lame on the straight showed decreased movement symmetry during lungeing, in particular with the lame limb on the inside of a hard circle. The variation within group questions straight-line movement symmetry as a sole measure of lameness without quantification of movement symmetry on the lunge, ideally on hard and soft surfaces to evaluate differences between reins and surfaces. In future, thresholds for lungeing need to be determined using simultaneous visual and objective assessment.
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Affiliation(s)
- T Pfau
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - C Jennings
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - H Mitchell
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - E Olsen
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK.,Department of Large Animal Sciences, Faculty of Health and Medical Science, University of Copenhagen, Taastrup, Denmark
| | - A Walker
- Equine Studies, Moulton College, Moulton, UK
| | - A Egenvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - S Tröster
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - R Weller
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - M Rhodin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Affiliation(s)
- J. Dixon
- Equine Referral Hospital; Royal Veterinary College; Hatfield Hertfordshire UK
| | - R. Weller
- Equine Referral Hospital; Royal Veterinary College; Hatfield Hertfordshire UK
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Roach J, Pfau T, Bryars J, Unt V, Channon S, Weller R. Sagittal distal limb kinematics inside the hoof capsule captured using high-speed fluoroscopy in walking and trotting horses. Vet J 2014; 202:94-8. [DOI: 10.1016/j.tvjl.2014.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 06/10/2014] [Accepted: 06/11/2014] [Indexed: 11/16/2022]
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Tambaschi M, Dunkel B, Mullard J, Wood R, Piercy R, Weller R. Latero-Oblique Radiography as a Diagnostic Tool for Equine Cervical Osteoarthritis. Equine Vet J 2014. [DOI: 10.1111/evj.12323_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M. Tambaschi
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - B. Dunkel
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - J. Mullard
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - R. Wood
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - R.J. Piercy
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - R. Weller
- Royal Veterinary College; North Mymms Hertfordshire UK
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Dixon J, Lam R, Weller R, Smith M, Piercy R. Comparison and Clinical Application of CT and MRI for Evaluation of the Equine Cranial Nerves. Equine Vet J 2014. [DOI: 10.1111/evj.12323_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J. Dixon
- Equine Referral Hospital; Department of Clinical Sciences and Services; Royal Veterinary College; London UK
| | - R. Lam
- Equine Referral Hospital; Department of Clinical Sciences and Services; Royal Veterinary College; London UK
| | - R. Weller
- Equine Referral Hospital; Department of Clinical Sciences and Services; Royal Veterinary College; London UK
| | - M. Smith
- Equine Referral Hospital; Department of Clinical Sciences and Services; Royal Veterinary College; London UK
| | - R.J. Piercy
- Equine Referral Hospital; Department of Clinical Sciences and Services; Royal Veterinary College; London UK
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Whitmore J, Dakin S, Weller R, Mair T, Sherlock C. Interobserver Agreement of Standing Magnetic Resonance Imaging for Assessment of Deep Digital Flexor Tendon Pathology. Equine Vet J 2014. [DOI: 10.1111/evj.12323_57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J.K. Whitmore
- Royal Veterinary College; North Mymms; Hawkshead Lane Hertfordshire AL9 7TA UK
| | - S.G. Dakin
- Royal Veterinary College; North Mymms; Hawkshead Lane Hertfordshire AL9 7TA UK
| | - R. Weller
- Royal Veterinary College; North Mymms; Hawkshead Lane Hertfordshire AL9 7TA UK
| | - T.S. Mair
- Bell Equine Veterinary Clinic; Mereworth Maidstone Kent ME18 5GS UK
| | - C.E. Sherlock
- Bell Equine Veterinary Clinic; Mereworth Maidstone Kent ME18 5GS UK
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Agass R, Wilson A, Weller R, Pfau T. The Relationship Between Foot Conformation, Foot Placement and Motion Symmetry in the Equine Hindlimb. Equine Vet J 2014. [DOI: 10.1111/evj.12323_44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R.F. Agass
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - A.M. Wilson
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - R. Weller
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - T. Pfau
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
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Affiliation(s)
- R Weller
- The Royal Veterinary College; Hatfield United Kingdom
| | - A Love
- The Royal Veterinary College; Hatfield United Kingdom
| | - B Clark
- The Royal Veterinary College; Hatfield United Kingdom
| | - R Smith
- The Royal Veterinary College; Hatfield United Kingdom
| | - T Pfau
- The Royal Veterinary College; Hatfield United Kingdom
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Affiliation(s)
- C Brocklehurst
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
| | - R Weller
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
| | - T Pfau
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
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Affiliation(s)
- R Parkes
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
| | - T Pfau
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
| | - R Weller
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
| | - T Witte
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
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39
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Affiliation(s)
- R Weller
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
| | - J Bryars
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
| | - J Roach
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
| | - T Pfau
- The Royal Veterinary College; Hatfield Hertfordshire United Kingdom
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Dakin SG, Lam R, Rees E, Mumby C, West C, Weller R. Technical set-up and radiation exposure for standing computed tomography of the equine head. EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12127] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- S. G. Dakin
- Department of Clinical Sciences and Services; Royal Veterinary College; Equine Referral Hospital; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - R. Lam
- Department of Clinical Sciences and Services; Royal Veterinary College; Equine Referral Hospital; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - E. Rees
- Department of Clinical Sciences and Services; Royal Veterinary College; Equine Referral Hospital; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - C. Mumby
- Department of Clinical Sciences and Services; Royal Veterinary College; Equine Referral Hospital; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
| | - C. West
- Severn X-ray supplies Ltd; Unit 7, Bicton Business Park, Isle Lane, Bicton Shrewsbury Shropshire SY3 8DY UK
| | - R. Weller
- Department of Clinical Sciences and Services; Royal Veterinary College; Equine Referral Hospital; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA UK
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Brocklehurst C, Weller R, Pfau T. Effect of turn direction on body lean angle in the horse in trot and canter. Vet J 2013; 199:258-62. [PMID: 24360754 DOI: 10.1016/j.tvjl.2013.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 11/07/2013] [Accepted: 11/13/2013] [Indexed: 10/26/2022]
Abstract
Turning is commonly used as a diagnostic aid in equine lameness examinations. Forces experienced on the circle differ from those in a straight line, necessitating an inward lean of the body and asymmetric head/pelvic excursion, which are important parameters for lameness investigations. To better understand gait adaptations to lungeing in normal horses, the effect of turn direction on body lean in trot and in canter warrants further investigation. In this study, it was hypothesised that, on average and independent of gait, the observed body lean angle would be consistent with the ratio between gravitational and centripetal acceleration, but with variations for individual horses showing differences between reins. Twenty horses were fitted with a global positioning system (GPS)-aided inertial measurement unit quantifying body lean angle, speed and circle radius in trot and canter in both directions. The difference between predicted (from speed and circle radius) and observed body lean (Δobs,pred) was compared between horses, directions and gaits using a generalised linear model. The mean speed and circle radius were 3.3m/s and 4.9 m in trot and 4.5m/s and 5.7 m in canter. Mean Δobs,pred was -1.1° (range -7.6° to 5.4°) in trot and -0.8° (range -7.6° to 8.3°) in canter and was significantly different between horses (P<0.0001) and directions (P<0.0001), but not between gaits (P=0.14). Interactions between horse and direction (P<0.0001) and horse and gait (P=0.011) were also significant. Horses leaned marginally less into the circle than predicted. However, this study provides additional evidence for horse specific adaptations, showing significant differences between horses and turn directions but not between gaits.
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Affiliation(s)
- C Brocklehurst
- Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
| | - R Weller
- Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
| | - T Pfau
- Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
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Mumby C, Bouts T, Sambrook L, Danika S, Rees E, Parry A, Rendle M, Masters N, Weller R. Validation of a new radiographic protocol for Asian elephant feet and description of their radiographic anatomy. Vet Rec 2013; 173:318. [DOI: 10.1136/vr.101696] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- C. Mumby
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Herts AL9 7TA UK
| | - T. Bouts
- Al Wabra Wildlife Preservation Al Shahaniya Qatar
| | - L. Sambrook
- Zoological Society of London; Regent's Park London NW1 4RY UK
| | - S. Danika
- Christodoulou Mixed Animal Veterinary Practice; 51 Kondyli Str Trikala 42100 Greece
| | - E. Rees
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Herts AL9 7TA UK
| | - A. Parry
- Willows Veterinary Centre and Referral Service; Highlands Road, Shirley Solihull West Midlands B90 4NH UK
| | - M. Rendle
- Zoological Society of London; Regent's Park London NW1 4RY UK
| | - N. Masters
- Zoological Society of London; Regent's Park London NW1 4RY UK
| | - R. Weller
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Herts AL9 7TA UK
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Mitchell H, Jennings C, Olsen E, Walker A, Weller R, Pfau T. Lunging on soft and hard ground: differences between sound and mildly lame horses. J Equine Vet Sci 2013. [DOI: 10.1016/j.jevs.2013.08.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Finding EJT, Ciasca T, Pinilla MJ, Driver CJ, Johns IC, Weller R, Volk HA. Diagnosis, treatment and outcome of spinal lymphoma in a pony. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - T. Ciasca
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - M. J. Pinilla
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - C. J. Driver
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - I. C. Johns
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - R. Weller
- Royal Veterinary College; North Mymms Hertfordshire UK
| | - H. A. Volk
- Royal Veterinary College; North Mymms Hertfordshire UK
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Mitchell H, Jennings C, Olsen E, Walker A, Weller R, Pfau T. Movement Symmetry Patterns During Lungeing in Trot on Hard and Soft Surface Differ Between Sound and Mildly Forelimb Lame Horses. Equine Vet J 2013. [DOI: 10.1111/evj.12145_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H. Mitchell
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - C. Jennings
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - E. Olsen
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - A. Walker
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - R. Weller
- Royal Veterinary College; North Mymms; Hertfordshire; UK
| | - T. Pfau
- Royal Veterinary College; North Mymms; Hertfordshire; UK
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Roach J, Williams S, Unt V, Bryars J, Pfau T, Weller R. High-Speed Fluoroscopy: A Novel Method for Dynamic Imaging of the Equine Foot. Equine Vet J 2013. [DOI: 10.1111/evj.12145_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J.M. Roach
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hatfield; AL9 7TA; UK
| | - S.B. Williams
- Department of Comparative Biomedical Sciences; Royal Veterinary College; London; NW1 0TU; UK
| | | | | | | | - R. Weller
- Department of Veterinary Clinical Sciences; Royal Veterinary College; Hatfield; AL9 7TA; UK
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Gunning P, Smith A, Fox V, Bolt DM, Lowe J, Sinclair C, Witte TH, Weller R. Development and validation of an equine nerve block simulator to supplement practical skills training in undergraduate veterinary students. Vet Rec 2013; 172:450. [PMID: 23486507 DOI: 10.1136/vr.101335] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Lameness is the most common presenting complaint in equine practice. Performing diagnostic nerve blocks is an integral part of any lameness work-up, and is therefore an essential skill for equine practitioners. However, the opportunities for veterinary students to practice this skill are limited. The aim of this study was to design and validate an equine nerve block simulator. It was hypothesised that the simulator would improve students' ability and enhance their confidence in performing nerve blocks. A simulator was built using an equine forelimb skeleton and building foam. Wire wool targets were placed under the foam in the positions corresponding to the anatomical location of the most palmar digital, abaxial and low four-point nerve blocks and attached to an electrical circuit. The circuit became complete when the operator placed a needle in the correct position and immediate audible feedback with a buzzer was provided. To validate the simulator, it was compared with two established teaching methods: cadaver training and theoretical training with a hand-out. Cadaver-trained students achieved the best results (73 per cent correct blocks), compared with simulator-trained students (71 per cent correct blocks), and a hand-out trained group (58 per cent correct blocks). Feedback obtained with a questionnaire showed that students enjoyed simulator training more, and that they felt more confident in performing diagnostic nerve blocks than the other two groups. The equine nerve block simulator provides a safe, cost-effective method to supplement the teaching of diagnostic analgesia to undergraduate veterinary students.
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Affiliation(s)
- P Gunning
- The Royal Veterinary College, Hawkshead Lane, North Mymms, Herts, Hatfield AL9 7TA, UK
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Bolt DM, Read RM, Weller R, Sinclair C, David FH. Standing low-field magnetic resonance imaging of a comminuted central tarsal bone fracture in a horse. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- D. M. Bolt
- Equine Referral Hospital; Royal Veterinary College; Hatfield UK
| | - R. M. Read
- Equine Referral Hospital; Royal Veterinary College; Hatfield UK
| | - R. Weller
- Equine Referral Hospital; Royal Veterinary College; Hatfield UK
| | - C. Sinclair
- Equine Referral Hospital; Royal Veterinary College; Hatfield UK
| | - F. H. David
- Equine Referral Hospital; Royal Veterinary College; Hatfield UK
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Abstract
Hoof testers are commonly used in equine practice. In this study, we determined the intraoperator and interoperator reliability of force application with hoof testers for different groups: experienced veterinarians, novices and farriers. For this purpose, we have developed and validated an instrumented hoof tester. Forces varied significantly between the different regions of the foot for experienced operators applying the highest forces to the heels, then the frog, then the toe, and the lowest forces to the quarters. Novices applied significantly more force to the toe versus the frog. Intraoperator reliability varied significantly between regions and operators. Novices had the narrowest width of limits of agreement for the frog and heel, but the widest for the toe and the quarters, whereas farriers had the narrowest width of agreement for the toe and quarter. Force application differed significantly between groups for the frog and heel regions, but not the toe and quarters. Veterinarians applied higher forces to the frog compared with farriers and novices, and higher forces to the heel compared with novices. This study showed that hoof tester forces vary widely within and between operators, and standardisation of hoof tester use is needed to make this diagnostic test more reliable.
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Affiliation(s)
- J L Arndt
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
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