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INTRODUCTION: The project «Healthy claws - the foundation for the future¼ aims to establish a Swiss national claw health monitoring based on digital recordings by claw trimmers during claw trimming. To assess claw health on the participating farms, between-herd prevalence, within-herd prevalence and cow prevalence of all claw disorders based on the «ICAR Claw Health Atlas¼ were calculated during this study. Claw trimmers underwent an intensive training and examination in order to ensure data quality. To guarantee the representativity of the prevalences, only farm claw trimmings were considered, where ≥ 80 % of the cows in a herd were trimmed. The calculations were based on 7108 cows and 403 heifers from 238 farms, during the period from February 2020 to February 2021. At least one claw disorder was present in 99,2 % of the farms, with 49,6 % of the heifers and 77,7 % of the cows having at least one claw disorder. The high prevalence is seen as a result of all ICAR claw disorders being considered, whereas not all of them are painful and consequently not all of them cause lameness. The absence of lameness assessment limits the evaluation of existing herd problems. High between-herd and cow prevalences were observed for the following claw disorders: heel horn erosion (92,9 %/64,7 %), digital dermatitis (55,9 %/20,7 %), white line disease (81,5 %/17,7 %) and sole hemorrhage (66,4 %/11,6 %). Asymmetric claws, corkscrew claws, scissor claws, horn fissure, interdigital phlegmon, swelling of the coronet and/or bulb and toe necrosis had low prevalences. The proportion of cows treated with a hoof block (0,5 %) was comparatively small in regard of the cows suffering from ulcers (5,6 %) and white line abscesses (2,5 %). The median within-herd prevalence of digital dermatitis was 5,6 %, with a maximal within-herd prevalence of 87,5 %. Despite the contagious nature of digital dermatitis, no increase of between-herd and cow prevalence has been observed in the past ten years throughout Switzerland. Based on this data, the Swiss claw health situation can be monitored, compared over time and improved in the future.

INTRODUCTION: Le projet « Des onglons sains-de bon pied vers l'avenir ¼ vise à établir une surveillance nationale suisse de la santé des onglons basée sur des enregistrements numériques effectués par des ongleurs pendant le parage des onglons. Pour évaluer la santé des onglons dans les exploitations participantes, la prévalence entre les troupeaux, la prévalence au sein du troupeau et la prévalence chez les vaches de tous les troubles des onglons sur la base de l' « ICAR Claw Health Atlas ¼ ont été calculées au cours de cette étude. Les ongleurs ont subi une formation et un examen intensifs afin de garantir la qualité des données. Afin de garantir la représentativité des prévalences, seuls ont été considérés les parages d'exploitations où ≥ 80% des vaches du troupeau ont été parées. Les calculs ont été basés sur 7108 vaches et 403 génisses de 238 élevages, au cours de la période de février 2020 à février 2021. Au moins une lésion des onglons était présente dans 99,2 % des élevages, avec 49,6 % des génisses et 77,7 % des vaches présentant au moins une lésion. La prévalence élevée est considérée comme le résultat de toutes les lésions selon ICAR, alors que toutes ne sont pas douloureuses et par conséquent ne provoquent pas toute de boiterie. L'absence d'évaluation de la boiterie limite l'évaluation des problèmes de troupeau existants. Des prévalences élevées entre les troupeaux et les vaches ont été observées pour les lésions des onglons suivantes : érosion de la corne du talon (92,9%/64,7%), dermatite digitale (55,9%/20,7%), maladie de la ligne blanche (81,5 %/17,7%) et hémorragie de la sole (66,4%/11,6%). Les onglons asymétriques, les onglons en tire-bouchon, les onglons en ciseaux, la fissure de la corne, le phlegmon interdigital, le gonflement de la couronne et/ou la nécrose de la pince avaient de faibles prévalences. La proportion de vaches traitées avec un sabot (0,5 %) était comparativement faible par rapport aux vaches souffrant d'ulcères (5,6%) et d'abcès de la ligne blanche (2,5%). La prévalence médiane intra-troupeau de dermatite digitale était de 5,6%, avec une prévalence intra-troupeau maximale de 87,5%. Malgré le caractère contagieux de la dermatite digitale, aucune augmentation de la prévalence entre troupeaux et vaches n'a été observée au cours des dix dernières années dans toute la Suisse. Sur la base de ces données, la situation sanitaire des onglons en Suisse peut être surveillée, comparée dans le temps et améliorée à l'avenir.

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INTRODUCTION: The main goal of the resources project «Healthy claws - the foundation for the future¼ is to establish a Swiss national claw health monitoring programme for cattle, similar to what has already been established in other countries (e. g. Finland, Sweden). So far in the course of the project, 30 claw trimmers have been trained to use a digital recording software. An appropriate training concept and information to the work environment of Swiss claw trimmers are necessary to ensure that the recorded claw health data is of good quality. The newly developed training programme for claw trimmers was evaluated using the 30 first trained claw trimmers of the project. The training consisted of group events and individual schooling sessions, during which the claw trimmers were trained to recognise, classify and digitally record foot and claw disorders according to the «ICAR claw health atlas¼. At the end of the training programme, demographic and work relevant data about the claw trimmers was collected and their abilities when using the recording software, as well as recognising and classifying foot and claw disorders using pictures or live animals, were evaluated. The demographic and work relevant data collected at the end of the training showed an ageing of the profession (43% of the participants were over 50 years old), a lack of full-time claw trimmers (23% of the claw trimmers worked 90% or 100%), a neglect of locomotion scoring during claw trimming (no locomotion scoring standing from 60% and in movement from 33% of the participants) and a broad use of the Swiss claw trimming method (90% of the claw trimmers indicate using this method). An average Cohens kappa value of 0,74, and thus an overall substantial agreement with the first author, respectively the ICAR Atlas, was achieved for the identification and classification of foot and claw disorders. It was also noted, that all the participants were capable of using the recording software in practice after their schooling. The calculation of Cohens kappa values helps to recognise claw trimmers which fall below the limiting value and therefore show an insufficient agreement. These claw trimmers can thus be excluded from the scientific evaluation or undergo further training. It was concluded that the described training concept is suitable to establish a national claw health monitoring programme.

INTRODUCTION: L'objectif principal du projet «Des onglons sains ­ de bon pied vers l'avenir¼ est la mise en place d'un programme national suisse de surveillance de la santé des onglons des bovins, similaire à ce qui a déjà été mis en place dans d'autres pays (par ex. Finlande, Suède). Jusqu'à présent, au cours du projet, 30 pareurs d'onglons ont été formés à l'utilisation d'un logiciel de documentation électronique. Un concept de formation approprié et des informations sur l'environnement de travail des pareurs suisses sont nécessaires pour garantir la bonne qualité des données enregistrées. Le programme de formation nouvellement mis au point a été évalué à l'aide des 30 premiers pareurs formés. La formation a consisté en des formations de groupe et des formations individuelles, au cours desquelles les pareurs ont été formés à reconnaître, classifier et enregistrer électroniquement les maladies des onglons selon l'«Atlas ICAR santé des onglons¼. À la fin de la formation, des données démographiques et professionnelles concernant les pareurs ont été collectées et leurs capacités à utiliser le logiciel d'enregistrement, à reconnaître et classifier les maladies des onglons à l'aide d'images ou sur des animaux vivants, ont été évaluées. Les données démographiques et professionnelles collectées à l'issue de la formation ont entre autre montré un vieillissement de la profession (43% des participants avaient plus de 50 ans), un manque d'ongleurs à temps plein (23% des ongleurs travaillent à 90% resp. 100%), une négligence de la notation de la motricité lors du parage des onglons (pas de notation de la motricité stationnaire chez de 60% et en mouvement chez33% des participants) et une large utilisation de la méthode suisse de parage des onglons (90% des ongleurs indiquent utiliser cette méthode). Une valeur moyenne du coefficient kappa de Cohens de 0,74, et donc une concordance globale avec le premier auteur, respectivement l'Atlas ICAR, a été obtenue pour l'identification et la classification des maladies des onglons. Il a également été constaté que tous les participants étaient capables après leur formation d'utiliser le logiciel d'enregistrement dans la pratique. Le calcul de valeurs kappa de Cohens permet de reconnaître les pareurs qui descendent en dessous d'une valeur limite et présentent donc une concordance insuffisante. Ces pareurs peuvent ainsi être exclus de l'évaluation scientifique ou suivre une formation complémentaire. On peut en conclure que le concept de formation décrit convient pour la mise en place d'un programme national de surveillance de la santé des onglons.

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OBJECTIVES: (1) To report the clinical features of luxation of the superficial digital flexor tendon in dogs and (2) to report the outcome and complications of a novel surgical technique where postoperative immobilisation was not used. MATERIALS AND METHODS: Medical records from one Swedish veterinary hospital were retrospectively reviewed for cases of superficial digital flexor tendon treated by the author, between July 2007 and August 2019, where a temporary restraining pin was used as part of the surgical repair. RESULTS: Twenty-three procedures were performed in 19 dogs. Fourteen of the dogs were Shetland Sheepdogs with five other breeds represented. Lateral luxation occurred in all but one case. Minor complications occurred in eight cases (35%). Major complications requiring unplanned surgery occurred in three cases (13%). All cases ultimately returned to their pre-injury level of activity. CLINICAL SIGNIFICANCE: The use of a temporary restraining pin is useful in the surgical repair of superficial digital flexor tendon luxation. All cases were successfully treated without using post-operative immobilisation of the tarsal joint. Plain radiography is unreliable in the identification of morphological defects of the calcaneus.

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BACKGROUND: The results of lower limb amputation, especially in critically ill patients with severe endogenous intoxication, sepsis, multi-organ failure and severe concomitant diseases are still unsatisfactory. Guillotine amputation is a method routinely used to reduce wound complications associated with wet gangrene and severe cases of diabetic foot, however, it is unclear how well it could help to decrease mortality and improve functional outcome when dealing with critically ill patients. THE OBJECTIVE: of the study was to estimate the effectiveness of two-phase method of urgent low limb amputation among critically ill patients with high risk of complications. The effectiveness was evaluated in terms of perioperative mortality, frequency of early complications and ultimate level of limb loss. MATERIALS AND METHODS: Two cohort groups of patients with acute lower limb gangrene were retrospectively matched. Approximately 25.8% of patients from the comparison (control) group (N = 240) died without surgery due to severity of their condition and ineffective pre-operative treatment. The remaining patients underwent one-phase high-level amputation after 48-72 h of pre-operative intensive care. The experimental group consisted of 153 patients who underwent guillotine amputation at the lower part of tibia (34.6%), knee disarticulation (32.0%), or open thigh amputation (33.3%), depending on the level of irreversible soft tissue necrosis. The reamputation with the stump shaping was performed later when their health status improved. RESULTS: The assessment of treatment outcomes showed that the two-phase amputation in critically ill patients (i) decreased the mortality from 48.7 to 37.9%, (ii) reduced the risk of wound complications from 20.9 to 11.1%, and (iii) improved functional results by saving the knee joint in 34.6 versus 4.5% in comparison/control group. CONCLUSION: The method of two-phase amputation is recommended for critically ill patients.

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OBJECTIVES: To determine the prevalence and risk factors for symptoms related to gloves, and the relation between symptoms and immunological evidence of type 1 hypersensitivity to latex in a United Kingdom health care setting. METHODS: A cross sectional survey was carried out among 773 employees at a British hospital. A self administered questionnaire was used to collect information about symptoms related to gloves and associated risk factors in a sample of hospital staff who were likely to use gloves at work. All of those who reported symptoms suggestive of type 1 hypersensitivity were invited for skin prick testing and measurement of specific IgE to latex (RAST). RESULTS: Among the 372 responders, symptoms related to gloves were common, 49% reported redness or itching of the hands, 14% reported urticaria, and 6% reported chest tightness. However, the frequency of positive skin prick tests and RASTs was surprisingly low (only two subjects tested positive). CONCLUSIONS: These findings indicate the need for caution in the interpretation of symptoms related to gloves even when they seem to suggest type 1 hypersensitivity.

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