A retrospective study of laminitis was carried out to identify risk factors associated with this disease on an East Anglian farm with approximately 1000 animals living in an area of 1000 acres. Medical records between January 1997 and May 2000 and between April 2005 and March 2008 were reviewed, and the age, sex, weight (kg), height (inches [in] and hands [H]) and weight-to-height ratio (kg/in) was recorded. The prevalence, incidence and seasonality of laminitis were determined and their relationship to the monthly temperature, rainfall and hours of sunshine was evaluated. Averaged over the six years, the highest prevalence (2.6 per cent) and incidence (16 cases/1000 animals) of laminitis occurred in May. The findings of a multivariate analysis revealed that females (P=0.007, odds ratio [OR] 1.46, 95 per cent confidence interval [CI] 1.1053 to 1.9646) and light animals (P ≤ 0.001, OR=0.995, 95 per cent CI =0.9932 to 0.9963) had the greatest risk of developing laminitis. A positive association was found between hours of sunshine and incidence (P=0.007, relative risk [RR] 1.009, 95 per cent CI 1.001 to 1.012) and prevalence (P=0.002, RR 1.008, 95 per cent CI 1.003 to 1.012) of laminitis. The data suggest that there is a relationship between season, sex of the animal and the development of laminitis.
The aim of this study was to evaluate both the repeatability (intraobserver agreement) and reproducibility (interobserver agreement) of Obel grading, the most widely accepted method for describing the severity of equine laminitis. The study comprised two parts. In study A, to test intraobserver agreement, 25 ponies were graded twice by a single blinded experienced equine veterinary surgeon, on the first occasion via clinical examination and on the second occasion via a video recording of the initial clinical examination. In study B, to test interobserver agreement, video recordings of 13 ponies were graded independently by 58 blinded experienced equine veterinary surgeons. A weighted kappa (kappa(w)) statistic was used to determine the measure of agreement between gradings. Intraobserver agreement of Obel grading was shown to be moderate (kappa(w)=0.54), and interobserver agreement was found to be substantial (kappa(w)=0.65). In addition, intraobserver agreement improved from moderate to substantial (kappa(w) increased from 0.54 to 0.70) when the Obel grades were grouped and horses were categorised as either sound, or as having mild (grade 1 or 2) or severe (grade 3 or 4) lameness.
All non-vestibular schwannoma NF2 presentations in childhood had significant diagnostic delay. We emphasise the importance of detailed assessment of skin and eyes in unusual presentations and propose an aide to prompt timely referral to specialist services.
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