Apprendre l'anatomie radiographique en présentiel ou en ligne ? Une étude randomisée contrôlée.

Résumé L'enseignement de l'anatomie repose sur diverses techniques: les cours, les dissections, les modèles 3D ou encore les supports en ligne. Ces derniers sont généralement considérés comme des moyens d'apprentissage complémentaires. Cette étude vise à comparer les performances des étudiants vétérinaires (N=83) en anatomie radiographique (radioanatomie) après un apprentissage en ligne ou conventionnel, et de voir dans quelle mesure ces méthodes sont interchangeables. Trois stratégies sont comparées : apprentissage en ligne exclusif, apprentissage en ligne avec des os de chevaux, apprentissage sur radiographies conventionnelles avec des os de chevaux. Les performances au test de rotation mentale et au test de connaissance en radioanatomie sont similaires entre les 3 groupes à la base, lors du test préliminaire. Après l'apprentissage (test final), les scores de rotation mentale et de radioanatomie augment significativement de 6.7/40 points (CI : 5.2­8.2; p < .001) et de 5.1/20 points (CI: 4.3­5.9; p< .001). Il n'y a pas de différence entre les groupes pour les scores de rotation mentale et de radioanatomie après l'apprentissage. Le score de rotation mentale est influencé par le genre, et significativement plus élevé chez les hommes que chez les femmes au test préliminaire (M= 23.0, SD = 8.8 vs. M= 16.5, SD= 6.9; p= .001) et au test final (M= 32.1, SD= 5.5 vs. M= 22.7, SD= 8.6; p< .001). Les performances en radioanatomie ne sont pas influencées par le genre. Ces résultats suggèrent que l'enseignement de la radioanatomie peut être réalisé en présentiel avec des radiographies conventionnelles ou en ligne. Cette interchangeabilité entre apprentissage en présentiel et en distanciel est intéressante au regard des impératifs liés aux crises sanitaires, et des besoins d'adaptation rapide en distanciel. This translation was provided by the authors. To view the original article visit: https://doi.org/10.3138/jvme-2021-0153.

Can Online Teaching of Radiographic Anatomy Replace Conventional On-Site Teaching? A Randomized Controlled Study.

Different modalities such as lectures, dissections, 3D models, and online learning are used for teaching anatomy. To date, online learning has been considered a useful additional didactic tool. This study aimed to compare veterinary students' performance in radiographic anatomy (radio-anatomy) after online or classroom-based teaching to assess the extent to which the two methods were interchangeable. Three strategies were compared in a cohort of 83 learners. Students were committed to online learning only, online learning with the use of specimen equine bones, or learning on conventional radiographs with specimen equine bones. At baseline (pre-test), scores from a mental rotation test and radio-anatomy knowledge test were similar between groups. After training (post-test), scores in mental rotation and radio-anatomy significantly increased by 6.7/40 units (95% CI: 5.2-8.2; p < .001) and 5.1/20 units (95% CI: 4.3-5.9; p < .001), respectively. There was no difference in scores for mental rotation and radio-anatomy knowledge between groups at post-test. Gender influenced the mental rotation, with men scoring significantly higher than women at pre-test (M = 23.0, SD = 8.8 vs. M = 16.5, SD = 6.9; p = .001) and post-test (M = 32.1, SD = 5.5 vs. M = 22.7, SD = 8.6; p < .001). However, radio-anatomy knowledge was not influenced by gender. These results suggest radio-anatomy teaching can be safely achieved with either conventional radiographs or online resources. This is of interest since, due to the COVID-19 outbreak, rapidly changing from on-site to online methods for teaching veterinary medical education proved necessary.

Postanaesthetic effects of ketamine-midazolam and ketamine-medetomidine on gastrointestinal transit time in rabbits anaesthetised with isoflurane.

BACKGROUND: Gastrointestinal stasis is a common perianaesthetic complication in rabbits. The objective of this study was to assess the impact on gastrointestinal transit time of ketamine-midazolam (KMZ) versus ketamine-medetomidine (later antagonised by atipamezole) (KMT-A) in rabbits anaesthetised with isoflurane. METHODS: This was a cross-over, randomised, single-blinded, controlled, experimental trial. Seven healthy adult New Zealand White rabbits were used. Gastrointestinal transit time was assessed by contrast radiography in awake rabbits. Presence of contrast medium in the small intestine (gastric transit time), in the caecum (small intestinal transit time) and in faeces in the colon was assessed. One week later, 55 minutes isoflurane anaesthesia was induced with ketamine (15 mg/kg) and either midazolam (3 mg/kg) or medetomidine (0.25 mg/kg) by intramuscular injection. Thirty minutes after discontinuation of isoflurane, atipamezole (0.5 mg/kg) was administered only to rabbits in KMT-A treatment. Gastrointestinal transit time was then assessed in both treatment groups, beginning 30 minutes after cessation of isoflurane administration. Two weeks later, the treatment groups were interchanged. RESULTS: Gastric and small intestinal transit times were significantly longer with KMT-A (92±109 minutes and 214±119 minutes, respectively) than with KMZ (1±0 minutes and 103±6 minutes, respectively) and in the awake state (7±7 minutes and 94±32 minutes, respectively). CONCLUSION: Clinicians should therefore be aware of the potential gastrointestinal side effects of KMT-A, particularly in rabbits at risk for gastrointestinal stasis.

Use of Intravitreal Injection of Gentamicin in 71 Horses With Equine Recurrent Uveitis.

We report a retrospective evaluation of intravitreal gentamicin (6 mg in 0.3 mL solution) injection in 71 horses with equine recurrent uveitis between 2010 and 2016. Aqueous flare and hyalitis were scored at the baseline in all horses, then at 15, 30, 60, 90, 180, 365, and 730 in 37, 46, 30, 25, 22, 18, and 11 horses, respectively. Forty-two animals had a global score of inflammation (sum of scores for aqueous flare and hyalitis) of zero at the last examination (number of re-examinations per horse ranged from 1 to 5). Among the 29 remaining horses, four were not reassessed after the intervention. The individual inflammation scores of the remaining 25 horses improved in 21 cases, whereas it slightly deteriorated in four cases (number of re-examinations ranged from 0 to 6). Ocular hypotension, lens opacities, and retinal folds were observed, respectively, in 92%, 78%, and 28% of the 71 eyes at the baseline, and in 80%, 90%, and 36% of the 11 eyes re-evaluated at 2 years. A telephone inquiry about all horses among owners and referring veterinarians conducted in 2016 at least 6 months after the more recent injections indicated that 70 horses did not develop a new observable episode of inflammation and did not need ocular medication. Although the results of this study should be discussed with reservation, it indicated that low-dose intravitreal injection of gentamicin could be a useful treatment to maintain ocular quiescence in equine recurrent uveitis.

Ultrasound anatomy of the normal stifle in the sheep.

Though the ovine stifle is commonly used as a model in research, there is no description of its anatomy at ultrasonography (US). The objective of this study was to provide reference US images of the ovine stifle that are relevant in musculoskeletal research. Four pairs of hindlimbs were scanned, whilst four other pairs were frozen and cut in different planes to compare gross anatomy to US scans. In another pair, the synovial compartments of the stifle were injected and scanned. This study demonstrated that US could be used to assess the ovine stifle. Several structures of clinical interest could be identified with cranial, lateral and medial approaches, such as (a) the tendons of m. quadriceps femoris, m. gluteobiceps, m. popliteus, (b) the common tendon of m. peroneus tertius-extensor longus digitorum-extensor digiti III proprius, (c) the patellar ligament, (d) the medial and lateral collateral ligaments, (e) the cranial horn and middle segment of medial and lateral meniscus, and (f) the synovial recesses. However, the caudal approach was not successful to identify caudal anatomical structures of the joint, due to the muscular mass, that is the caudal aspects of the articular surfaces of the femoral and tibial condyles, the caudal horns of the menisci and the supracondylar synovial recesses. In addition, US remained challenging to assess the internal structures such as cruciate ligaments and articular surfaces. The feasibility of US needs to be tested in vivo.

The effect of maropitant on intraoperative isoflurane requirements and postoperative nausea and vomiting in dogs: a randomized clinical trial.

OBJECTIVE: To establish if preoperative maropitant significantly reduced intraoperative isoflurane requirements and reduced clinical signs associated with postoperative nausea and vomiting (PONV) in dogs. STUDY DESIGN: Randomized clinical trial. ANIMALS: Twenty-four healthy, client-owned dogs undergoing routine ovariohysterectomy. METHODS: Premedication involved acepromazine (0.03 mg kg-1) combined with methadone (0.3 mg kg-1) intramuscularly 45 minutes before anaesthetic induction with intravenous (IV) propofol, dosed to effect. Meloxicam (0.2 mg kg-1) was administered intravenously. Dogs were randomly assigned to administration of saline (group S; 0.1 mL kg-1, n=12) or maropitant (group M; 1 mg kg-1, n=12) subcutaneously at time of premedication. Methadone (0.1 mg kg-1 IV) was repeated 4 hours later. Anaesthesia was maintained with isoflurane in oxygen, dosed to effect by an observer unaware of group allocation. The dogs were assessed hourly, starting 1 hour postoperatively, using the short form of the Glasgow Composite Pain Score (GCPS), and for ptyalism and signs attributable to PONV [score from 0 (none) to 3 (severe)] by blinded observers. Owners completed a questionnaire at the postoperative recheck. RESULTS: Overall mean±standard deviation end-tidal isoflurane percentage was lower in group M (1.19±0.26%) than group S (1.44±0.23%) (p=0.022), but was not significantly different between groups at specific noxious events (skin incision, ovarian pedicle clamp application, cervical clamp application, wound closure). Cardiorespiratory variables and postoperative GCPS were not significantly different between groups. Overall, 50% of dogs displayed signs attributable to PONV, with no difference in PONV scores between groups (p=0.198). No difference in anaesthetic recovery was noted by owners between groups. CONCLUSIONS: Maropitant reduced overall intraoperative isoflurane requirements but did not affect the incidence of PONV. CLINICAL RELEVANCE: Maropitant provided no significant benefits to dogs undergoing ovariohysterectomy with this anaesthetic and analgesic protocol, although clinically significant reductions in isoflurane requirements were noted.

The effect of experience, simulator-training and biometric feedback on manual ventilation technique.

OBJECTIVE: To determine the frequency of provision and main providers (veterinary surgeons, nurses or trainees) of manual ventilation in UK veterinary practices. Furthermore, to determine the variation in peak inspiratory (inflation) pressure (PIP), applied to a lung model during manual ventilation, by three different groups of operators (inexperienced, experienced and specialist), before and after training. STUDY DESIGN: Questionnaire survey, lung model simulator development and prospective testing. METHODS: Postal questionnaires were sent to 100 randomly selected veterinary practices. The lung model simulator was manually ventilated in a staged process over 3 weeks, with and without real-time biometric feedback (PIP display), by three groups of volunteer operators: inexperienced, experienced and specialist. RESULTS: The questionnaires determined that veterinary nurses were responsible for providing the majority of manual ventilation in veterinary practices, mainly drawing on theoretical knowledge rather than any specific training. Thoracic surgery and apnoea were the main reasons for provision of manual ventilation. Specialists performed well when manually ventilating the lung model, regardless of feedback training. Both inexperienced and experienced operators showed significant improvement in technique when using the feedback training tool: variation in PIP decreased significantly until operators provided manual ventilation at PIPs within the defined optimum range. Preferences for different forms of feedback (graphical, numerical or scale display), revealed that the operators' choice was not always the method which gave least variation in PIP. CONCLUSIONS AND CLINICAL RELEVANCE: This study highlighted a need for training in manual ventilation at an early stage in veterinary and veterinary nursing careers and demonstrated how feedback is important in the process of experiential learning. A manometer device which can provide immediate feedback during training, or indeed in a real clinical setting, should improve patient safety.

Assessment of a computed tomography guided injection technique of the lumbo-sacral disc in sheep.

OBJECTIVES: Recent data indicate that degeneration of intervertebral discs occurs naturally in sheep, with a higher prevalence at the level of the lumbo-sacral disc. The objective of this ex vivo study was to evaluate a computed tomography (CT) guided method of injection into the ovine lumbo-sacral disc. METHODS: Six euthanatized sheep were used for identification of the approach plane, the optimal direction of the needle and the mean distance from skin to disc. Dissection after injection of coloured ink was used to determine the anatomical structures that were penetrated. In seven other animals, all spines were assessed beforehand by CT and magnetic resonance imaging to determine whether disc pathology was present. The final position of the needle was assessed by CT to determine the accuracy of the technique. Contrast agent was injected to identify any problems associated with administration of liquid into the disc. RESULTS: The CT guided injection technique was easy to perform and enabled adequate positioning of the needle into all (n = 7) lumbo-sacral discs. Distance between the skin and the disc ranged between 12 and 17 cm. No organ, vascular or nervous structure was penetrated and the needle path remained intramuscular without penetration of the peritoneal cavity. Contrast medium leaked out through three degenerate discs. CLINICAL SIGNIFICANCE: The current study described a consistently safe and accurate CT guided injection technique to the lumbo-sacral disc for future in vivo experimental studies that will use sheep as animal model for human intervertebral disc disease disease.

Cardiorespiratory parameters in the awake pigeon and during anaesthesia with isoflurane.

OBJECTIVE: To determine baseline cardiovascular and respiratory variables in the awake pigeon, and to assess those variables during anaesthesia at the individual minimal anaesthetic concentration (MAC) of isoflurane during spontaneous breathing. STUDY DESIGN: Prospective, experimental trial. ANIMALS: Seven healthy adult pigeons weighing a mean ± standard deviation (SD) of 438 ± 38 g. METHODS: Heart rate (HR), heart rhythm, respiratory rate (fR), end-expired carbon dioxide tension (Pe'CO2), indirect systolic arterial pressure (SAP) and cloacal temperature (T) were measured in birds in the awake state (after acclimatization to handling). Two weeks later, the pigeons were anaesthetized with isoflurane in order to determine their MAC and evaluate the same cardiovascular and respiratory variables during a further 40 minutes of isoflurane anaesthesia. RESULTS: In the awake pigeon, mean ± SD HR, SAP, fR, Pe'CO2 and T were, respectively, 155 ± 28 beats minute(-1), 155 ± 21 mmHg, 34 ± 6 breaths minute(-1), 38 ± 8 mmHg (5.1 ± 1.1 kPa) and 41.8 ± 0.5 °C. Mean isoflurane MAC was 1.8 ± 0.4%. During maintenance of anaesthesia at MAC, although no significant decreases between values obtained in the awake and anaesthetized states emerged in HR or respiratory rate, significant decreases in SAP and cloacal temperature and an increase in Pe'CO2 were observed. No arrhythmia was identified in awake pigeons, whereas second- and third-degree atrioventricular blocks occurred under isoflurane. CONCLUSIONS AND CLINICAL RELEVANCE: Isoflurane MAC in pigeons appeared to be higher than in other avian species. Isoflurane anaesthesia in pigeons resulted in hypercapnia, hypotension, mild hypothermia and second- and third-degree atrioventricular blocks.

Strong stability and host specific bacterial community in faeces of ponies.

The horse, as a hindgut fermenter, is reliant on its intestinal bacterial population for efficient diet utilisation. However, sudden disturbance of this population can result in severe colic or laminitis, both of which may require euthanasia. This study therefore aimed to determine the temporal stability of the bacterial population of faecal samples from six ponies maintained on a formulated high fibre diet. Bacterial 16S rRNA terminal restriction fragment length polymorphism (TRFLP) analyses of 10 faecal samples collected from 6 ponies at regular intervals over 72 hour trial periods identified a significant pony-specific profile (P<0.001) with strong stability. Within each pony, a significantly different population was found after 11 weeks on the same diet (P<0.001) and with greater intra-individual similarity. Total short chain fatty acid (SCFA) concentration increased in all ponies, but other changes (such as bacterial population diversity measures, individual major SCFA concentration) were significant and dependent on the individual. This study is the first to report the extent of stability of microbes resident in the intestinal tract as represented with such depth and frequency of faecal sampling. In doing so, this provides a baseline from which future trials can be planned and the extent to which results may be interpreted.