Introduction For many patients, audio-visual appointments have provided a timely and efficient way of seeking advice, assessment and treatment for their hand injuries during the NHS response to COVID-19. This study aimed to explore the experience of hand units across the UK in determining the safe and judicious use of audio-visual outpatient care for the management of acute upper limb trauma. Methods An online cross-sectional survey was sent to the therapy leads of hand units across the UK. Questions focused on the experience of using audio-visual technology in the management of upper limb trauma, and the relevant factors in determining its appropriate use. A deductive mixed methods analysis was used to identify both common themes and capture community experience and characteristics. Results A total of 51 out of 76 hand therapy units completed the survey; a response rate of 67%. Of these, 82% (42/51) reported using audio-visual technology to manage upper limb trauma during the UK COVID-19 lockdown. When determining patient suitability for audio-visual consultations, 73% (37/51) of respondents reported the use of COVID-19 guidelines, but only 35% (18/51) reported the use of a clinical decision-making tool. In agreement with our experience at Salisbury Hospital Foundation Trust, 92% (47/51) had concerns relating to the use of audio-visual care. Conclusion The choice of safely managed remote care or in-person consultation has, to date, largely relied on the discretion of the clinician. A carefully designed clinical decision-making tool for the management of upper limb trauma is needed for use both in clinical practice and in future service planning.
The efficacy of a novel oral endectocide containing moxidectin, sarolaner and pyrantel was investigated in client-owned dogs with natural infections of Toxocara canis, Toxascaris leonina, Ancylostoma caninum and Uncinaria stenocephala.
MethodsDogs infected with any of the four gastrointestinal nematode species were enrolled in this controlled, masked, randomized study. In total, 194 dogs were treated once orally with the combination of sarolaner (1.2 to 2.4 mg/kg), moxidectin (24 to 48 µg/kg) and pyrantel (5 to 10 mg/kg) and 97 dogs were treated with a positive control product containing afoxolaner (2.50-5.36 mg/kg) and milbemycin oxime (0.50-1.07 mg/kg). Faecal egg counts were conducted before, and 7 days after treatment administration. Efficacy was based on the post-treatment reduction in geometric mean egg counts (per gram faeces) compared to pre-treatment.
ResultsTwo hundred dogs were infected with T. canis, 80 with A. caninum, 36 with U. stenocephala, and 16 with T. leonina. Fifty dogs had mixed infections with two or more species. Post-treatment geometric mean fecal egg counts for T. canis, A. caninum, T. leonina, and U. stenocephala relative to pretreatment counts were significantly (P<0.0001) reduced by ≥98.3% in the group treated with the combination of sarolaner, moxidectin and pyrantel, and by ≥ 97.4% in the afoxolaner and milbemycin oxime-treated group. Both products were well tolerated.
Statement (conclusions)Oral administration of the combination of 1.2 mg/kg sarolaner, 24 µg/kg moxidectin and 5.0 mg/kg pyrantel provided effective treatment of roundworm and hookworm infection in dogs.
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BEST ORAL ABSTRACTSMain Sessions | Landtagssaal Friday May 16 | 09:45-10:45 1167 Metabolic profiling using ex-vivo proton magic angle spinning magnetic resonance spectroscopy (1H-MAS-MRS) detects myocardial injury in experimental autoimmune myocarditis (EAM)Recently, breathing maneuvers have been shown to be associated with a similar vascular response as seen with vasodilatory agents like adenosine. Yet, there has been no data on its potential diagnostic utility in the presence of coronary artery stenosis. In swine, we investigated whether hyperventilation followed by a long breath-hold can detect an abnormal regional response in the presence of coronary artery stenosis. Eighteen anaesthetized swine were prepared with a blood flow probe on the left anterior descending coronary artery (LAD) and a femoral arterial catheter. In ten of these animals, a significant stenosis of the LAD was created with a hydraulic occluder and quantified by measuring the fractional flow reserve (FFR).Background: The cardiovascular magnetic resonance (CMR) derived native myocardial T1 is decreased in patients with Anderson Fabry disease (AFD) even before left ventricular hypertrophy (LVH) occurs and may be a first non-invasive measure of myocyte storage. The relationship of native T1 lowering prior to hypertrophy to other candidate early phenotype markers and its reproducibility as a clinical test are unknown. Methods: sixty-three pts, 34 (54%) female, mean age 43 + 15 years with confirmed (genotyped) AFD underwent CMR, ECG and echocardiographic assessment. LVH was absent in 25 (40%) of the pts. Native T1 mapping was performed with both Modified Look-Locker Inversionrecovery(MOLLI)and ashortenedversion (Sh-MOLLI)sequences ona1.5 Tesla magnet. Twenty-one patients underwent a second scan later on the same day to assess inter-study reproducibility. Results were compared with 63 healthyvolunteersmatched for gender and age. Results: The mean native T1 in AFD (LVH+), (LVH-) and healthy subjects (HS) was 853 + 50ms, 904 + 46ms and 968 + 32ms (for all p , 0.0001), Figure 1. Native T1 assessment showed high inter-study, intra-observer and inter-observer agreement with intra-class correlation coefficients (ICC) of 0.99, 0.98, 0.97 (ShMOLLI) and 0.98, 0.98, 0.98 (MOLLI). In AFD LVH-individuals, low native T1 was associated with reduced echocardiographicbased global longitudinal speckle tracking strain (-19 + 2% vs -21 + 2%, p ¼ 0.036) and early diastolic function impairment (E/E'¼ 7[6-8] vs 5[5-7], p ¼ 0.045), Figure 2. Conclusion: Native T1 mapping in AFD is a reproducible technique. T1 reduction prior to the onset of LVH is associated with early diastolic and systolic changes measured by echocardiography.
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