Evaluating gender discrepancies in the time to successful match into a small animal surgery residency program.

OBJECTIVE: To determine any association between gender and likelihood of first attempt match and overall time to match into an American College of Veterinary Surgery (ACVS)-registered small animal surgical residency program (SASRP). STUDY DESIGN: Online survey. SAMPLE POPULATION: A total of 100 (77 female, 23 male) ACVS small animal surgery residents or diplomates participating in a SASRP during the past 5 years. METHODS: An online survey was sent to eligible individuals. Respondents anonymously provided information related to demographics, postgraduate internships, and qualifications at the time of each surgical residency application. First attempt and overall match success were evaluated by gender through univariable analysis and then via a multivariable model. RESULTS: Men were 2.89 times more likely to match directly into a SASRP following a rotating internship than women (p = .041), and women completed more total internships than men prior to successful match into a SASRP (p = .030); however, men were found to have more publications at the time of first residency application (p < .001) or successful match (p = .018). Multivariable analysis revealed no association between gender on overall match success or first attempt match rate when considering all other qualifications. CONCLUSION: No evidence for gender bias was found during the Veterinary Internship and Residency Matching Program (VIRMP) SASRP applicant selection process; however, gender specific patterns in research qualifications were identified. IMPACT: Gender-blinded assessment is not considered necessary for the VIRMP small animal surgical resident selection process. Efforts should be made to educate applicants about the impact of research on the residency selection process and encourage research engagement of female students and graduates.

A narrative review of the impact of work hours and insufficient rest on job performance.

OBJECTIVE: This review discusses the scientific evidence regarding effects of insufficient rest on clinical performance and house officer training programs, the associations of clinical duty scheduling with insufficient rest, and the implications for risk management. STUDY DESIGN: Narrative review. METHODS: Several literature searches using broad terms such as "sleep deprivation," "veterinary," "physician," and "surgeon" were performed using PubMed and Google scholar. RESULTS: Sleep deprivation and insufficient rest have clear and deleterious effects on job performance, which in healthcare occupations impacts patient safety and practice function. The unique requirements of a career in veterinary surgery, which may include on-call shifts and overnight work, can lead to distinct sleep challenges and chronic insufficient rest with resultant serious but often poorly recognized impacts. These effects negatively impact practices, teams, surgeons, and patients. The self-assessment of fatigue and performance effect is demonstrably untrustworthy, reinforcing the need for institution-level protections. While the issues are complex and there is no one-size-fits-all approach, duty hour or workload restrictions may be an important first step in addressing these issues within veterinary surgery, as it has been in human medicine. CONCLUSION: Systematic re-examination of cultural expectations and practice logistics are needed if improvement in working hours, clinician well-being, productivity, and patient safety are to occur. CLINICAL SIGNIFICANCE (OR IMPACT): A more comprehensive understanding of the magnitude and consequence of sleep-related impairment better enables surgeons and hospital management to address systemic challenges in veterinary practice and training programs.

Retention of basic surgical skills in veterinary students.

OBJECTIVE: To quantify veterinary students' retention of surgical skills after a 5-month period without practice. STUDY DESIGN: Prospective longitudinal descriptive study. SAMPLE POPULATION: Convenience sample of second year veterinary students (n = 57). METHODS: Students practiced ovariohysterectomy (OVH) on a model during 4 clinical skills laboratories during spring 2021. Students were assessed performing OVH on their model using a validated 22-item rubric. Students not meeting expectations repeated their assessment 2 weeks later. All students had a 5-month period, including summer break, without skills practice. Students were again assessed performing OVH on their model in the fall. Students' rubric scores and pass rates were compared before and after summer break. RESULTS: Students scored lower on their retention test in fall (median = 43) than at the spring assessment (median = 56, P < .001). No difference was detected between lower and higher performing students. Five students (9%) did not meet expectations on their first assessment; more students (17/57, 30%) failed to meet expectations on their retention test (P = .004). CONCLUSION: Students experienced a decay in the surgical skills required to perform OVH after a 5-month period without practice, regardless of the quality of their initial performance. CLINICAL SIGNIFICANCE: Veterinary educators should emphasize the importance of continual practice to maintain skills and should consider assisting students in regaining skills during review sessions on models to improve surgical skill retention after a prolonged break.

Characterizing Exposure to Physical Risk Factors during Veterinary Surgery with Wearable Sensors: A Pilot Study.

OCCUPATIONAL APPLICATIONSVeterinarians provide comprehensive health services for animals, but despite exposure to similar occupational and safety hazards as medical physicians, physical risk factors for these doctors and healthcare teams have not been characterized. In this pilot study, we used wearable sensor technology and showed that veterinary surgeons commonly experience static and demanding postures while performing soft tissue and orthopedic surgeries. Observations showed that muscle activation was highest in the right trapezius. Job factors such as surgical role (attending vs. assisting) and surgical specialty (soft tissue vs. orthopedics) appeared to influence exposure to physical risk factors. These findings suggest a need to consider the unique demands of surgical specialties in order to address the key risk factors impacting injury risks among veterinarians. For example, static postures may be a priority for soft tissue surgeons, while tools that reduce force requirements are more pressing for orthopedic surgeons.

BACKGROUND: Although musculoskeletal fatigue, pain, and injuries are commonly reported among surgeons in veterinary medicine, few studies have objectively characterized the exposure to physical risk factors among veterinary surgeons. Purpose: This study aimed to characterize muscle activation and postures of the neck and shoulders during live veterinary surgeries in the soft tissue and orthopedic specialties. Methods: Forty-four ergonomic exposure assessments (exposures) were collected during 26 surgical procedures across five surgeons. Exposures were collected from both soft tissue (n = 23) and orthopedic (n = 21) specialties. Physical risk factors were characterized by: (1) directly measuring muscle activation and posture of the neck and shoulders, using surface electromyography and inertial measurement units, respectively; and (2) collecting self-reported workload, pain, and stiffness. Results: Across the 44 exposures, neck and back symptoms respectively worsened after the surgery in 27% and 14% of the exposures. Veterinary surgeons exhibited neck postures involving a mean of 17° flexion during the surgical procedures. Static postures were common, occurring during 53­80% of the procedures. Compared to soft tissue procedures (e.g., 13.2% MVC in the right trapezius), higher muscle activity was observed during orthopedic procedures (e.g., 27.6% MVC in the right trapezius). Conclusions: This pilot study showed that physical risk factors (i.e., muscle activity and posture of the neck/shoulder) can be measured using wearable sensors during live veterinary surgeries. The observed risk factors were similar to those documented for medical physicians. Further studies are needed to bring awareness to opportunities for improving workplace ergonomics in veterinary medicine and surgery.

Abstract Presentation at Two Veterinary Surgery Conferences and the Impact on Publication Rate.

OBJECTIVES: The aim of this study was to compare the publication rate (PR) and report descriptive findings from abstracts presented at the American College of Veterinary Surgeons (ACVS), the Veterinary Orthopaedic Society (VOS), and those presented at both conferences. STUDY DESIGN: All conference abstracts from 2001 to 2010 ACVS and VOS meetings were reviewed. PR in peer-reviewed journals was evaluated and compared between Group 1 (abstracts presented at ACVS only; n = 1,277), Group 2 (abstracts presented at VOS only; n = 645), and Group 3 (abstracts presented at both conferences; n = 121) abstracts. Abstracts were assigned a level of evidence (LoE) score. RESULTS: Approximately 6% of all abstracts evaluated were presented at two scientific meetings (Group 3). The PR of Group 1 (66%) and Group 3 (62%) abstracts was significantly higher than that of Group 2 (45%). The majority of abstracts were assigned a low LoE (3 or 4). Once presented, most Group 3 abstracts took <12 months to be submitted and <24 months to be published. CONCLUSION: This study found that a limited number of abstracts were presented at both ACVS and VOS, and PR was significantly different between those presented at ACVS only or both ACVS and VOS compared with VOS only. There was no significant difference in PR between Group 1 and Group 3 abstracts. This study has provided the initial comparison between abstracts presented at two veterinary surgical conferences.

Preoperative skin asepsis protocols using chlorhexidine versus povidone-iodine in veterinary surgery: A systematic review and meta-analysis.

OBJECTIVE: To provide a systematic assessment of the efficacy of preoperative skin asepsis using chlorhexidine versus povidone-iodine based protocols for surgical site infection (SSI) prevention in veterinary surgery. STUDY DESIGN: Systematic meta-analytical review according to PRISMA-P guidelines. SAMPLE POPULATION: Studies comparing preoperative skin asepsis protocols using chlorhexidine versus povidone-iodine in veterinary surgery identified by systematic search between 1990 and 2020. METHODS: A search using MEDLINE/Pubmed, Web of Science and CAB Abstracts was performed, followed by secondary searches of Google Scholar, Proquest Dissertation and Theses, and relevant bibliographic articles. Primary and secondary outcome measures were the efficacy of skin asepsis protocols using chlorhexidine versus povidone-iodine on SSI incidence and skin bacterial colonization, respectively. A meta-analysis was performed with a random-effect model, with effect size calculated as risk ratio (RR) or mean standard deviation (MSD) with 95% CI. Statistical significance was set at P < .05. RESULTS: Among 1067 publications that met the initial search criteria, 9 relevant studies were eligible for analysis. No difference in the incidence of postoperative SSI or skin bacterial colonization between preoperative asepsis protocols using chlorhexidine versus povidone-iodine was found. Insufficient information and detail were frequent among studies and precluded a clear assessment of bias. CONCLUSION: This study showed that asepsis protocols using chlorhexidine were comparable to povidone-iodine in preventing postoperative SSI and reducing skin bacterial colonization. CLINICAL SIGNIFICANCE: Given the limitations of the studies that were included in terms of both quality and quantity, more high-quality randomized controlled trials are needed to confirm these conclusions.

Evaluation of a brief video intervention aimed at UK-based veterinary surgeons to encourage neutering cats at four months old: A randomised controlled trial.

In the UK, it is currently recommended that owned cats be neutered from four months of age. However, its uptake is inconsistent across the veterinary profession. Here we assess the effect of a brief video intervention that aimed to encourage four month neutering, whilst preserving clinical autonomy. We compare this theory-driven approach with traditional information giving and a control group. Veterinary surgeons who regularly undertook feline neutering work in the UK but did not routinely neuter cats at four months and/or recommend four month neutering for client owned cats were randomised into three groups (n = 234). Participants received either no information, a written summary of evidence or the video. The primary behaviour outcomes were the recommending and carrying out of neutering cats at four months. Evaluative, belief and stages of change measures were also collected. Self-reported outcomes were assessed pre-intervention, immediately post-intervention, two months post-intervention and six months post-intervention. At two months, participants that had received the video intervention were significantly more likely to have started recommending neutering cats at four months. At six months, participants that had received the video intervention were significantly more likely to have started carrying out neutering cats at four months. There were no significant behaviour changes for the other groups. At two months, the video intervention was associated with a significant increase in thinking about, and speaking to colleagues about, four-month neutering, relative to the control group. The written summary of evidence had no similar effect on stages of change, despite it being perceived as a significantly more helpful resource relative to the video. To conclude, a brief one-off video intervention resulted in an increase in positive behaviours towards neutering cats at 4 months, likely mediated by the social influences of the intervention prompting the opportunity to reflect and discuss four-month neutering with colleagues.

Vertebrectomia total e estabilização com pinos e polimetilmetacrilato como tratamento para luxação entre vértebras torácicas em cão ­ relato de caso / Total vertebrectomy and stabilization with pins and polymethylmethacrylate as treatment for thoracic vertebral luxation in a dog - case report

As lesões decorrentes de atropelamento são as principais causas de fraturas e luxações vertebrais, ocasionando graus variáveis de injúrias vertebrais e medulares. O presente trabalho tem como objetivo relatar a ocorrência de lesão traumática em coluna vertebral de cão sem raça definida, com quatro anos de idade, resultando em luxação T11-12, com exposição de T11 e secção medular, estando o paciente paraplégico, com sinais de lesão em neurônio motor superior e ausência de nocicepção profunda em membros pélvicos. O tratamento de escolha foi a vertebrectomia de T11, associada ao alinhamento de T10-12 com introdução de pinos e fixação com polimetilmetacrilato (PMMA) associado à ceftriaxona. Em decorrência de lesão na pleura parietal no trans-cirúrgico, optou-se pela toracostomia para introdução de tubo torácico, o qual permaneceu no paciente por quatro dias. No pós-operatório, o paciente apresentou recuperação satisfatória, sendo recomendado aos tutores a confecção de cadeira de rodas a fim de facilitar sua locomoção. A técnica mostrou-se satisfatória para minimizar as infecções passíveis de ocorrência em fraturas expostas, bem como melhorar a qualidade de vida do paciente, evitando-se dores crônicas.

Injuries resulting from being run over are the leading causes of vertebral fractures and dislocations, causing varying vertebral and spinal injuries. The present study aims to report the occurrence of traumatic injury to the spine of a mixed breed dog, aged four years, resulting in a T11-12 dislocation, with T11 exposure and spinal section, with the patient showing paraplegia, signs of an upper motor neuron lesion and absence of deep nociception in pelvic limbs. The treatment of choice was T11 vertebrectomy, associated with the alignment of T10-12 with the introduction of pins and fixation with polymethylmethacrylate (PMMA) associated with ceftriaxone. Due to a lesion in the parietal pleura during the surgery, thoracostomy was chosen to introduce a chest tube, which remained in the patient for four days. In the postoperative period, the patient presented a satisfactory recovery, and it was recommended that tutors make a wheelchair to facilitate their mobility. The technique proved to be satisfactory for minimizing infections that could occur in open fractures and improving the patient's quality of life, avoiding chronic pain.

Exenteração e confecção de retalho de padrão axial da artéria temporal superficial para tratamento de carcinoma espinocelular periocular em um felino / Exenteration and axial pattern flap of the superficial temporal artery for the treatment of periocular squamous cell carcinoma in a feline

O carcinoma espinocelular é uma neoplasia maligna dos ceratinócitos que tem como principal causa a exposição a raios ultravioletas. Os felinos constituem a espécie doméstica mais susceptível para o aparecimento desta neoplasia, sendo a face a região mais comum de acometimento, incluindo áreas do plano nasal, pina e pálpebras. No presente trabalho relata-se um felino, sem raça definida, fêmea, 12 anos de idade, 3kg, castrada, de pelagem branca, que foi atendida apresentando lesão extensa de caráter ulcerativo em região periocular de globo ocular esquerdo, com evolução de aproximadamente três meses, envolvendo ambas as pálpebras, superior e inferior. Após realização de avaliação clínica, os achados obtidos por meio da anamnese juntamente com o exame citológico, sugeriram como principal diagnóstico o carcinoma espinocelular. Para tratamento foi preconizado remoção cirúrgica, na qual demonstrou boa efetividade para tratamento dessa afecção. Após, o material foi enviado para análise histopatológica, sendo confirmado o diagnóstico. O paciente apresentou boa recuperação e evolução clínica do quadro, não apresentando nenhuma complicação no decorrer do tratamento. O prognóstico para este caso foi considerado bom, uma vez que não havia indícios de metástase no momento da realização dos exames complementares, e as margens da neoplasia se encontravam livres de células neoplásicas.

Squamous cell carcinoma is a malignant neoplasm of keratinocytes whose main cause is exposure to ultraviolet rays. The original felines are the domestic species most susceptible to the onset of this neoplasm, the face being the most common region of involvement, including areas of the nasal plane, pinna and eyelids. In the present study, we report a feline, mixed breed, female, 12 years old, 3kg, neutered, with white fur, who was treated for an enlarged ulcerative lesion in the periocular region of the left eyeball, with an evolution of approximately three months. involving both the upper and lower eyelids. After conducting a clinical valuation, the findings obtained through the anamnesis together with the cytological examination, suggested squamous cell carcinoma as the main diagnosis. For treatment before surgical removal, in the qualification good effectiveness to treat this condition. Afterwards, the material sent for histopathological analysis, the diagnosis being confirmed. The patient shows good recovery and clinical evolution of the condition, there is no complication or complication during the treatment. The prognosis for this case was considered good, since there was no evidence of metastasis at the time of the complementary tests, and as the neoplasia margins were free of neoplastic cells.

Electrophysiological and anatomical characterization of synaptic remodeling in the mouse whisker thalamus.

In the central nervous system, developmental and pathophysiologic conditions cause a large-scale reorganization of functional connectivity of neural circuits. Here, by using a mouse model for peripheral sensory nerve injury, we present a protocol for combined electrophysiological and anatomical techniques to identify neural basis of synaptic remodeling in the mouse whisker thalamus. Our protocol provides comprehensive approaches to analyze both structural and functional components of synaptic remodeling. For complete details on the use and execution of this protocol, please refer to Ueta and Miyata, (2021).

Protocol for in vivo and ex vivo assessments of glucose-stimulated insulin secretion in mouse islet ß cells.

Pancreatic islet ß cells secrete insulin in a biphasic manner when sensing high blood glucose level. This protocol describes the evaluation of different phases of insulin secretion, as well as basal, glucose-stimulated and total insulin secretion abilities, thereby enabling precise assessment of ß cell function both in vivo and ex vivo. The in vivo assay consists of intravenous tube imbedding surgery and hyperglycemic clamp. The ex vivo assay consists of islet isolation, dynamic perfusion and static immersion. For complete details on the use and execution of this protocol, please refer to Sun et al. (2021).

Retalho de padrão axial da artéria torácica lateral para reconstrução de lesão cutânea em região de cotovelo de cão: Relato de caso / Use of lateral thoracic axial pattern flap to repair cutaneous defect in a dog elbow: Case report

Os retalhos cutâneos são técnicas de escolha para reconstrução de grandes defeitos. Objetivou-se relatar o emprego do retalho de padrão axial da artéria torácica lateral em paciente com ferida cirúrgica ocasionada imediatamente após exérese de neoformação na região da articulação do cotovelo. Foi atendido paciente canino macho, 10 anos, pesando 12 kg, apresentando neoformação em tecidos moles, de grande volume, localizada na região medial do cotovelo. Como tratamento definitivo, implementou-se a exérese marginal da neoplasma seguida de reconstrução com a técnica de retalho de padrão axial da artéria torácica lateral. A técnica possibilitou completa síntese e oclusão do defeito, obtendo-se ótima recuperação pós operatória, não sendo observada deiscência de sutura ou necrose do retalho. Conclui-se que a implementação do retalho da artéria torácica lateral foi uma técnica viável na reconstrução em cotovelo após a exérese do neoplasma no paciente relatado, observando resultados satisfatórios quanto aos aspectos funcionais e cosméticos, após o período cicatricial.

Skin flaps are suitable methods of wound closure in large cutaneous defects. I The present study aims to report the use of lateral thoracic axial pattern flap to repair an elbow wound secondary to a neoplasm resection. A 10-year-old male dog weighing 12 kg was presented with a large soft tissue neoplasm in the medial aspect of the elbow. The patient underwent surgical resection of the neoplasm using the lateral thoracic cutaneous flap to achieve a complete defect closure, resulting in an excellent postoperative wound healing without suture failure or skin flap necrosis. It is concluded that the implementation of the lateral thoracic artery flap was a viable technique in elbow reconstruction after neoplasm excision in the reported patient, with satisfactory results regarding functional and cosmetic aspects after the healing period.

Reparo de ruptura crônica do ligamento patelar em um felino / Repair of chronic patelar ligament rupture in a cat

Relata-se o caso de uma felina, sem raça definida, de oito meses de idade e 3,6 kg, com queixa de impotência funcional completa do membro pélvico esquerdo após trauma. A paciente apresentava aumento de volume em região do joelho, dor à palpação e instabilidade patelar. O diagnóstico de ruptura do ligamento patelar foi realizado com base nos resultados do exame ortopédico, juntamente com exame radiográfico e ultrassonográfico do joelho. O método utilizado para reparo da lesão foi a sutura em oito com fio de tetrafluorcabono associado à sutura interrompida simples para aproximação das bordas do ligamento. Durante a reavaliação de trinta dias pós-operatório, a paciente já apresentava melhora significativa, com atividade funcional completa do membro e ausência de dor.

We report the case of an eight-month-old, 3.6 kg, crossbred feline, complaining of complete functional impotence of the left pelvic limb after trauma. The patient presented swelling in the knee region, pain on palpation and patellar instability. The diagnosis of patellar ligament rupture was based on the results of the orthopedic examination, together with radiographic and ultrasound examinations of the knee. The method used to repair the lesion was eight-point suture with tetrafluorocabono thread associated with simple interrupted suture for approximation of the ligament edges. During the thirty-day postoperative reassessment, the patient already presented significant improvement, with complete functional activity of the limb. and absence of pain.

Three-dimensional printed guides for screw placement in equine navicular bones.

OBJECTIVE: To determine the influence of a custom 3D-printed guide for placement of cortical bone screws in the equine navicular bone. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Eight pairs of normal adult equine forelimbs. METHODS: A 3.5 × 55 mm cortical screw was placed in the longitudinal axis of each intact navicular bone. Screws were placed with a 3D-printed guide (3D) in one bone and with a traditional aiming device (AD) in the contralateral bone within each pair. Duration of surgery and the number of fluoroscopy images were compared between techniques. Screw placement was subjectively evaluated by gross examination and scored by three boarded veterinary surgeons. RESULTS: The use of a 3D-printed guide reduced the duration of surgery by 6.6 min (±1.5 min) compared to traditional screw placement (20.7 min ± 4.8 min, p < .01). Fewer peri-operative fluoroscopic images were obtained when the 3D guide was used (18 images ± 2.6 images vs. 40 images ± 5.1, p < .01). No difference was detected in navicular screw placement. CONCLUSION: The use of a 3D guide decreased the time required to place screws and the number of intraoperative images taken without affecting screw placement in intact navicular bones. CLINICAL RELEVANCE: 3D-printed guides can aid in the study, practice, and execution of surgical procedures reducing surgical time and radiation exposure throughout the operative period achieving similar results to those obtained with a conventional approach.

A survey of attributes of surgical resident applicants deemed important to American College of Veterinary Surgeons board-certified surgeons involved in resident selection and methods used to evaluate these attributes.

OBJECTIVE: To determine which attributes of residency applicants were most commonly assessed by large and small animal American College of Veterinary Surgeons diplomates and to determine which evaluation methods were perceived to assess those attributes. STUDY DESIGN: Online survey. SAMPLE POPULATION: American College of Veterinary Surgeons board-certified surgeons as of March 2019. METHODS: An online survey was sent to eligible individuals. Respondents rated the importance of 23 attributes assessed by the Veterinary Internship and Residency Matching Program (VIRMP) application as well the usefulness of interviews, conversations with people knowledgeable with the applicants, and review of the VIRMP packet for evaluating each of these attributes. Responses were compared between large and small animal practitioners and between individuals involved in residency selection (supervisors) and individuals not involved in residency selection (nonsupervisors). RESULTS: Surveys were completed by 221 individuals (14.6% response rate). Seventeen of the 23 attributes were considered important by most respondents. Grade point average (GPA) and class rank were used as screening tools by 73% and 65% of supervisors, respectively. Letters of reference (LOR) were ranked as the most important part of the VIRMP packet. Conversations with people knowledgeable with the applicant was the only method judged by most respondents to be appropriate to evaluate all 23 attributes. Responses were similar between large and small animal supervisors and nonsupervisors. CONCLUSION: Respondents considered conversations with people knowledgeable with the applicant to be the most useful methods for assessing a resident applicant, but LOR, GPA, and class rank were also important. IMPACT: Resident applicants and mentors can use this information to strengthen applications.