Embedding the Flipped Classroom Approach to Support Student Learning in Animal Handling and Clinical Skills: Practical Classes Throughout a Veterinary Curriculum.

A comprehensive bank of flipped classrooms was developed to help students prepare for animal handling and clinical skills practical classes. Flipped classroom is a type of blended learning. In the context of clinical skills, it is designed to provide students with online learning resources prior to attendance at practical classes.

Practical Tips for Setting Up and Running OSCEs.

Objective structured clinical examinations (OSCEs) are used to assess students' skills on a variety of tasks using live animals, models, cadaver tissue, and simulated clients. OSCEs can be used to provide formative feedback, or they can be summative, impacting progression decisions. OSCEs can also drive student motivation to engage with clinical skill development and mastery in preparation for clinical placements and rotations.

Comparison of a Silicon Skin Pad and a Tea Towel as Models for Learning a Simple Interrupted Suture.

There has been rapid growth in the range of models available for teaching veterinary clinical skills. To promote further uptake, particularly in lower-income settings and for students to practice at home, factors to consider include cost, availability of materials and ease of construction of the model. Two models were developed to teach suturing: a silicon skin pad, and a tea towel (with a check pattern) folded and stapled to represent an incision.

Radiographic classifications in Perthes disease.

Background and purpose - Different radiographic classifications have been proposed for prediction of outcome in Perthes disease. We assessed whether the modified lateral pillar classification would provide more reliable interobserver agreement and prognostic value compared with the original lateral pillar classification and the Catterall classification. Patients and methods - 42 patients (38 boys) with Perthes disease were included in the interobserver study.

A protocol for the use of closed reduction in children with developmental dysplasia of the hip incorporating open psoas and adductor releases and a short-leg cast: Mid-term outcomes in 113 hips.

Aims: Our aim was to assess the effectiveness of a protocol involving a standardised closed reduction for the treatment of children with developmental dysplasia of the hip (DDH) in maintaining reduction and to report the mid-term results.

Methods: A total of 133 hips in 120 children aged less than two years who underwent closed reduction, with a minimum follow-up of five years or until subsequent surgery, were included in the study. The protocol defines the criteria for an acceptable reduction and the indications for a concomitant soft-tissue release.

Varus proximal femoral osteotomy for hip dysplasia in adults.

A retrospective study was carried out to evaluate the role of varus proximal femoral osteotomy in relieving symptoms and improving function in adults affected by hip dysplasia. A group of 24 patients were identified that underwent 26 varus proximal femoral osteotomies between the period May 1979 and January 2001. All were investigated by dynamic hip arthrography to confirm restoration of congruency in the abducted position and the position of ''best fit''.

The place of valgus extension femoral osteotomy in the late management of children with Perthes' disease.

Despite considerable research into the aetiology and management of Perthes' Disease, patients late with symptoms related to serious femoral head deformity. The process of progressive deformity is discussed and the clinical signs which recognize it identified. The clinical signs of the established condition are shortening, loss of abduction proceeding to a flexion/adduction contracture with unstable movement and hinge abduction on the dynamic arthrogram.

Outcomes of subcapital cuneiform osteotomy for the treatment of severe slipped capital femoral epiphysis after skeletal maturity.

We reviewed prospectively, after skeletal maturity, a series of 24 patients (25 hips) with severe acute-on-chronic slipped capital femoral epiphysis which had been treated by subcapital cuneiform osteotomy. Patients were followed up for a mean of 8 years, 3 months (2 years, 5 months to 16 years, 4 months). Bedrest with 'slings and springs' had been used for a mean of 22 days (19 to 35) in 22 patients, and bedrest alone in two, before definitive surgery.

The management of avascular necrosis after slipped capital femoral epiphysis.

Avascular necrosis is a serious complication of slipped capital femoral epiphysis and is difficult to treat. The reported incidence varies from 3% to 47% of patients. The aims of treatment are to maintain the range of movement of the hip and to prevent collapse of the femoral head.

Lack of efficacy of a reduced microparticle diet in a multi-centred trial of patients with active Crohn's disease.

Background And Aims: Dietary microparticles, which are bacteria-sized and non-biological, found in the modern Western diet, have been implicated in both the aetiology and pathogenesis of Crohn's disease. Following on from the findings of a previous pilot study, we aimed to confirm whether a reduction in the amount of dietary microparticles facilitates induction of remission in patients with active Crohn's disease, in a single-blind, randomized, multi-centre, placebo controlled trial.

Methods: Eighty-three patients with active Crohn's disease were randomly allocated in a 2 x 2 factorial design to a diet low or normal in microparticles and/or calcium for 16 weeks.

Dietary sources of inorganic microparticles and their intake in healthy subjects and patients with Crohn's disease.

Dietary microparticles are non-biological, bacterial-sized particles. Endogenous sources are derived from intestinal Ca and phosphate secretion. Exogenous sources are mainly titanium dioxide (TiO2) and mixed silicates (Psil); they are resistant to degradation and accumulate in human Peyer's patch macrophages and there is some evidence that they exacerbate inflammation in Crohn's disease (CD).

Does Chiari osteotomy compromise subsequent total hip arthroplasty?

We compared 28 total hip arthroplasties done in dysplastic hips after previous Chiari osteotomy (group I) with a well-matched control group of 50 primary procedures (group II) done during the same period at an average follow-up of 5 years (range, 25-199 months). Group I required significantly less acetabular augmentation, had significantly shorter operative times, had less intraoperative blood loss, and had fewer complications than group II. There was no significant difference between the 2 groups in terms of clinical or radiographic outcome.

Hip arthrodesis with the dynamic hip screw.

The authors report a series of 10 patients (4 male, 6 female) with end-stage hip degeneration who underwent unilateral hip arthrodesis at an average age of 19 years (range 14-35). Surgery was performed with the patient in the supine position through a Watson-Jones approach and fixation was stabilized with the AO Dynamic Hip Screw (DHS). After surgery, patients were mobilized in a short hip spica.

Lateral shelf acetabuloplasty in Perthes' disease. A review of the end of growth.

The surgical treatment of Perthes' disease by femoral or innominate osteotomy is not as effective in those over the age of eight years as it is in the younger child. This has prompted the search for other types of management in those who are older. The preliminary results of the use of a lateral shelf acetabuloplasty for such cases have shown encouraging results at two years.

Slipped capital femoral epiphysis: is the displacement always posterior?

The initial direction of displacement on slipped capital femoral epiphysis is generally accepted to be posterior as a consequence of retroversion of the femoral neck. We report the case of a 15-year-old boy with slipped capital femoral epiphysis in the medial direction, confirmed by three-dimensional computerized imaging. This was associated with an elongated neck without retroversion of the femoral neck.

Valgus extension osteotomy for 'hinge abduction' in Perthes' disease. Results at maturity and factors influencing the radiological outcome.

Valgus extension osteotomy (VGEO) is a salvage procedure for 'hinge abduction' in Perthes' disease. The indications for its use are pain and fixed deformity. Our study shows the clinical results at maturity of VGEO carried out in 48 children (51 hips) and the factors which influence subsequent remodelling of the hip.

Test of stability as an aid to decide the need for osteotomy in association with open reduction in developmental dysplasia of the hip.

After open reduction for developmental dysplasia of the hip (DDH), a pelvic or femoral osteotomy may be required to maintain a stable concentric reduction. We report the clinical and radiological outcome in 82 children (95 hips) with DDH treated by open reduction through an anterior approach in which a test of stability was used to assess the need for a concomitant osteotomy. The mean age at the time of surgery was 28 months (9 to 79) and at the latest follow-up, 17 years (12 to 25).

Khat chewing and bladder neck dysfunction. A randomized controlled trial of alpha 1-adrenergic blockade.

Objective: To assess whether the effect of chewing khat leaves (Catha edulis) on the urodynamics of healthy males is altered by the selective alpha 1-adrenergic blocking agent indoramin in a prospective randomized double-blind controlled trial.

Subjects And Methods: The urodynamics of 11 healthy males were studied before and during a khat chewing session preceded by indoramin or placebo.

Results: Khat chewing produced a fall in average and maximum urine flow rate.

Southern hybridisation analysis of HBV DNA in peripheral blood leucocytes and of different cell types: changes during the natural history and with interferon-alpha therapy in patients with hepatitis B virus infection.

Hepatitis B virus (HBV) DNA was evaluated in peripheral blood mononuclear cells (PBMC) from 50 individuals utilising Southern hybridisation analysis. HBV DNA sequences were detected in PBMC from 16/29 (55 percent) of chronic hepatitis B virus (HBV) carriers with serum HBeAg and HBV DNA, compared with 1/8 (13%) of carriers with anti-HBe and HBV DNA negative (P = NS). Two of 7 patients with previous HBV infection and chronic liver disease had detectable HBV DNA in PBMC.

A morphometric analysis of osteoid collagen fibril diameter in osteogenesis imperfecta.

Osteogenesis imperfecta is a genetic disorder of connective tissue characterised by frequent bone fracture following minimal trauma. Mutations of type I procollagen genes have been widely reported as the cause of OI and such mutations have been shown to introduce kinks into the collagen molecule. A study was performed to examine type I collagen fibrils at the ultrastructural level in the transmission electron microscope (TEM).

Bone growth following lengthening for congenital shortening of the lower limb.

Bone and limb growth velocity ratios were studied in patients undergoing lengthening for unilateral congenital shortening of the lower limb. In 15 patients before lengthening, the length ratio (LR) between the normal and short sides remained constant with age. Consequently, the growth velocity ratio (GVR) between the normal and short sides also remained constant and equal to the LR.

Posterolateral release for resistant club foot.

We treated 37 infants with 53 idiopathic club feet by posterolateral release alone at a mean age of 2.4 months. They were reviewed after a mean follow-up of 10 years 7 months.

Comparison of serum procollagen III peptide concentrations and PGA index for assessment of hepatic fibrosis.

In early hepatic fibrosis, increased amounts of type III collagen are deposited. Persistently high serum concentrations of aminoterminal type III procollagen propeptide (PIIIP) correlate with the activity of the fibrogenic process. Another index for the detection of fibrosis, the PGA index, combines the prothrombin time, gamma-glutamyl transpeptidase activity, and serum apolipoprotein A1 concentration (the latter falls with progressive fibrosis).