Utility of follow-up radiographs in conservatively managed acute fifth metatarsal fractures.

Fifth metatarsal fractures are the most common fracture of the foot, with the majority being managed conservatively. A variety of treatment methods are described in the literature. Follow-up radiographs are taken to identify fracture displacement, and subsequently to assess for bony union throughout treatment. We assessed the utility of serial radiographic assessment in management of these fractures. Clinical notes and radiographs of 79 patients with fifth metatarsal fractures were analysed retrospectively. Serial radiographs were studied to identify displacement and the last X-ray was reviewed for evidence of fracture union. 96% of fractures were managed conservatively. 29% showed radiological healing at last clinic visit, the rest being discharged as were considered clinically healed. Similar fracture types were managed differently. 3 fractures were surgically treated after failed conservative management. 1 fracture showed displacement from initial radiographs, and was successfully managed conservatively. Without clear guidelines, these injuries are managed differently from a radiological perspective. Follow-up radiographs taken before 6-8 weeks do not appear to alter patient management. Based on the current study we present our recommendations for radiographic assessment of acute fifth metatarsal fractures.

How do German veterinarians use social networks? A study, using the example of the 'NOVICE' veterinary medicine network.

OBJECTIVE: NOVICE (Network Of Veterinary ICT in Education, http://www.noviceproject.eu/), is a professional online social network for veterinarians, lecturers and students of veterinary medicine as well as for e-Learning advisers and others working in establishments that teach veterinary medicine. This study sets out to investigate to what extent German veterinarians, lecturers, students of veterinary medicine and e-Learning representatives would accept a specialist network, what requirements would have to be met by an online social network, how to use web 2.0 tools [21], [30] and what advantages a specialist network could offer. METHODOLOGY: The investigation was carried out by analysing data from the Elgg platform database as well as using Google Analytics. Annual focus group surveys and individual interviews were carried out in order to perform an analysis of acceptance among network users. RESULTS: 1961 users from 73 different countries registered on the NOVICE site between 1 September 2010 and 21 March 2012. Germany represents the biggest user group, with 565 users (28.81%). During this period, most individual hits on the website came from Germany too. In total, 24.83% of all members are active, while 19.22% of German members participate actively. In terms of gender, there are significantly more female members than male members, both in the NOVICE network as a whole as well as in Germany. The most used web 2.0 tools are chat and email messaging services as well as writing wikis and contributing to forum discussions. The focus group surveys showed that respondents generally make use of other online communities too. Active members generally use more web 2.0 tools than in other networks, while passive members are generally more reluctant in all networks. All participants of the survey welcomed the idea of having a network specifically set up for the profession and believe that it could be very useful for veterinary medicine. CONCLUSIONS: The network and its membership figures developed very positively during the assessed time period. Until now, the focus of the content of contributions in NOVICE (Network of Veterinary ICT in Education) has been on veterinary medicine teaching supported by e-Learning. An increase in the number of members would, however, be beneficial in order to further develop the network so that valuable exchange of information and informal learning can also take place in other specialist areas of veterinary medicine.

Developing an online professional network for veterinary education: the NOVICE project.

An online professional network for veterinarians, veterinary students, veterinary educationalists, and ICT (Information and Communication Technology) educationalists is being developed under the EU (European Union) Lifelong Learning Programme. The network uses Web 2.0, a term used to describe the new, more interactive version of the Internet, and includes tools such as wikis, blogs, and discussion boards. Focus groups conducted with qualified and student veterinarians within the project's five founding countries (The Netherlands, Germany, United Kingdom, Hungary, Romania) demonstrated that online professional communities can be valuable for accessing information and establishing contacts. Online networks have the potential to overcome common challenges to face-to-face communities-such as distance, cost, and timing-but they have their own drawbacks, such as security and professionalism issues. The Network Of Veterinary ICt in Education (NOVICE) was developed using Elgg, an open-source, free social networking platform, after several software options had been considered. NOVICE aims to promote the understanding of Web 2.0, confidence to use social software tools, and participation in an online community. Therefore, the Web site contains help sections, Frequently Asked Questions, and access to support from ICT experts. Five months after the network's launch (and just over one year into the project) 515 members from 28 countries had registered. Further research will include analysis of a core group's activities, which will inform ongoing support for and development of informal, lifelong learning in a veterinary context.

Doppler-guided haemorrhoidal artery ligation with recto anal repair: a new technique for the treatment of symptomatic haemorrhoids.

PURPOSE: Doppler-guided haemorrhoidal artery ligation (DGHAL) is a minimally invasive surgical technique used to treat symptomatic haemorrhoids. In 2005, the DGHAL proctoscope was redesigned to incorporate a window through which a recto anal repair (RAR) could be performed to improve the outcome in patients with significant prolapse symptoms. The aim of this study was to observe the outcome of a series of consecutive DGHAL-RAR procedures. METHOD: Seventy-seven consecutive patients (49 male) underwent DGHAL-RAR for symptomatic haemorrhoids and were reviewed for a minimum of 6 months post-surgery. RESULTS: Fifty-seven (74%) of patients presented with both prolapse and bleeding symptoms. The median number of DGHALs performed was six, and the median number of RARs was two. Most (96%) patients were discharged the same day. At follow-up, 11 patients complained of recurrent symptoms, five of prolapse, four of bleeding and two of pruritus. Eight patients suffered with post-operative anal fissures. The procedure is recommended by 84.4% of patients 6 weeks post-surgery. CONCLUSION: DGHAL-RAR is safe, effective and well tolerated. It reduces the need for potentially dangerous excisional procedures. The RAR component is an effective addition to DGHAL in the short term for the treatment of prolapse, but longer follow-up will be required to demonstrate durability of the technique.

Teaching bovine abdominal anatomy: use of a haptic simulator.

Traditional methods of teaching anatomy to undergraduate medical and veterinary students are being challenged and need to adapt to modern concerns and requirements. There is a move away from the use of cadavers to new technologies as a way of complementing the traditional approaches and addressing resource and ethical problems. Haptic (touch) technology, which allows the student to feel a 3D computer-generated virtual environment, provides a novel way to address some of these challenges. To evaluate the practicalities and usefulness of a haptic simulator, first year veterinary students at the Royal Veterinary College, University of London, were taught basic bovine abdominal anatomy using a rectal palpation simulator: "The Haptic Cow." Over two days, 186 students were taught in small groups and 184 provided feedback via a questionnaire. The results were positive; the majority of students considered that the simulator had been useful for appreciating both the feel and location of key internal anatomical structures, had helped with their understanding of bovine abdominal anatomy and 3D visualization, and the tutorial had been enjoyable. The students were mostly in favor of the small group tutorial format, but some requested more time on the simulator. The findings indicate that the haptic simulator is an engaging way of teaching bovine abdominal anatomy to a large number of students in an efficient manner without using cadavers, thereby addressing some of the current challenges in anatomy teaching.

A mixed reality simulator for feline abdominal palpation training in veterinary medicine.

The opportunities for veterinary students to practice feline abdominal palpation are limited as cats have a low tolerance to being examined. Therefore, a mixed reality simulator was developed to complement clinical training. Two PHANToM premium haptic devices were positioned either side of a modified toy cat. Virtual models of the chest and some abdominal contents were superimposed on the physical model. The haptic properties of the virtual models were set by seven veterinarians; values were adjusted while the simulation was being palpated until the representation was satisfactory. Feedback from the veterinarians was encouraging suggesting that the simulator has a potential role in student training.

Laparoscopy in diagnosis and management of Meckel's diverticulum.

OBJECTIVE: The aim of this paper is to demonstrate that laparoscopy can successfully diagnose otherwise elusive Meckel's diverticuli and at the same time offer a therapeutic access for successful resection. MATERIALS AND METHODS: Two patients with anemia of unknown cause and a further patient with acute small bowel obstruction underwent diagnostic laparoscopy. A Meckel's diverticulum was identified in each case and successfully resected through a minilaparotomy. RESULTS: All three patients were successfully investigated and treated with laparoscopy with no morbidity or mortality. CONCLUSION: Laparoscopy is a safe and effective surgical modality for diagnosis of atypically presenting Meckel's diverticulum and has a therapeutic role that results in an excellent cosmetic result.