Equine uveitis in the UK: a retrospective study (2008–2018)

2019 ◽  
Vol 186 (3) ◽  
pp. 92-92
Author(s):  
Fernando Malalana ◽  
Jo L Ireland ◽  
Gina Pinchbeck ◽  
Cathy M McGowan
Keyword(s):  
Retrospective Study ◽  
General Hospital ◽  
Medical Records ◽  
Referral Hospital ◽  
North West ◽  
The North ◽  
The World ◽  
Recurrent Case ◽  
Hospital Population ◽  
The Uk

BackgroundUveitis appears to be less prevalent in the UK compared with other parts of the world and studies characterising the disease in the UK are lacking. The objectives of this retrospective study were to describe acute and recurrent cases presenting for management of uveitis in a referral hospital on the North West of England and compare the signalment of horses presenting with uveitis with the equine hospital population during the same period.MethodsMedical records of horses presented to the referral Equine Hospital, University of Liverpool with signs of uveitis between 2008 and 2018 were reviewed and clinical details extracted.ResultsSeventy horses presented with uveitis; 33 were classified as acute and 37 as recurrent cases. Sixteen of the horses were affected bilaterally. More bilateral cases were classified as recurrent than acute (P=0.04). No differences in age or sex were noted between acute and recurrent cases, or between cases and the general hospital population. Warmbloods and Appaloosas were over-represented when compared with the general hospital population (P<0.001). Twenty-one horses (30 per cent, 95 per cent CI 20.5 to 41.4) underwent surgery for the control of the uveitis. Fourteen of the 70 horses (20.0 per cent, 95 per cent CI 12.3 to 30.8) underwent enucleation.ConclusionWhile relatively uncommon in the UK, uveitis can affect horses from a relatively young age. The disease appears to have a relatively higher frequency than expected in Warmbloods and Appaloosas. It is more likely that a recurrent case will have both eyes affected.

scholarly journals FRI0649-HPR HYDROXYCHLOROQUINE PRESCRIBING AND OPHTHALMOLOGY SCREENING WITHIN RHEUMATOLOGY DEPARTMENTS IN THE NORTH-WEST OF THE UNITED KINGDOM: A PROSPECTIVE REGIONAL AUDIT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 928.2-929
Author(s):  
S. Juman ◽  
T. David ◽  
L. Gray ◽  
R. Hamad ◽  
S. Horton ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Service Level ◽  
High Risk Group ◽  
North West ◽  
The North ◽  
The United Kingdom ◽  
The Uk ◽  
Treatment Dosage ◽  
Sd Oct

Background:Hydroxychloroquine (HCQ) is widely used in the management of rheumatoid arthritis and connective tissue disease. The prevalence of retinopathy in patients taking long-term HCQ is approximately 7.5%, increasing to 20-50% after 20 years of therapy. Hydroxychloroquine prescribed at ≤5 mg/kg poses a toxicity risk of <1% up to five years and <2% up to ten years, but increases sharply to almost 20% after 20 years. Risk factors for retinopathy include doses >5mg/kg/day, concomitant tamoxifen or chloroquine use and renal impairment. The UK Royal College of Ophthalmologists (RCOphth) 2018 guidelines for HCQ screening recommend optimal treatment dosage and timing for both baseline and follow-up ophthalmology review for patients on HCQ, with the aim of preventing iatrogenic visual loss. This is similar to recommendations made by the American Academy of Ophthalmology (2016).Objectives:To determine adherence to the RCOphth guidelines for HCQ screening within the Rheumatology departments in the North-West of the UK.Methods:Data for patients established on HCQ and those initiated on HCQ therapy were collected over a 7 week period from 9 Rheumatology departments.Results:473 patients were included of which 56 (12%) were new starters and 417 (88%) were already established on HCQ. 79% of the patients were female, with median ages of 60.5 and 57 years for new and established patients respectively. The median (IQR) weight for new starters was 71 (27.9) kg and for established patients, 74 (24.7) kg.20% of new starters exceeded 5mg/kg daily HCQ dose. 16% were identified as high risk (9% had previously taken chloroquine, 5% had an eGFR <60ml/min/m2and 2% had retinal co-pathology). Of the high-risk group, 44% were taking <5mg/kg. In total, 36% of new starters were referred for a formal baseline Ophthalmology review.In the established patients, 74% were taking ≤5mg/kg/day HCQ dose and 16% were categorized as high risk (10% had an eGFR less than 60ml/min/m2, 3% had previous chloroquine or tamoxifen use and 2% had retinal co-pathology). In the high-risk group, 75% were not referred for spectral domain optical coherence tomography (SD-OCT). 41% of patients established on HCQ for <5 years, and 33% of patients on HCQ for >5 years were not referred for SD-OCT. Reasons for not referring included; awaiting 5 year review, previous screening already performed and optician review advised.Since the introduction of the RCOphth guidelines, 29% patients already established on HCQ had an alteration in the dosage of HCQ in accordance with the guidelines. In the high-risk group, 16% were not on the recommended HCQ dose.Conclusion:This audit demonstrates inconsistencies in adherence to the RCOphth guidelines for HCQ prescribing and ophthalmology screening within Rheumatology departments in the North-West of the UK for both new starters and established patients. Plans to improve this include wider dissemination of the guidelines to Rheumatology departments and strict service level agreements with ophthalmology teams to help optimize HCQ prescribing and screening for retinopathy.Acknowledgments:Drs. S Jones, E MacPhie, A Madan, L Coates & Prof L Teh. Co-1st author, T David.Disclosure of Interests:None declared

scholarly journals Gravity of injury and analgesia in patients who suffered traffic accidents

2008 ◽  
Vol 21 (3) ◽  
pp. 398-403 ◽  
Author(s):  
Ana Maria Calil ◽  
Cibele Andrucioli de Mattos Pimenta
Keyword(s):  
Retrospective Study ◽  
Outer Surface ◽  
Medical Records ◽  
Traffic Accidents ◽  
Emergency Services ◽  
World Health ◽  
Analgesic Drugs ◽  
Body Regions ◽  
The World ◽  
Reference Hospital

OBJECTIVE: Identifying the frequency and gravity of injuries in patients who suffered accidents in traffic and the analgesic drugs utilized. METHODS: Retrospective study, with a sample of 200 medical records of patients admitted to the emergency services of a reference hospital for trauma care. The gravity of the injuries was characterized by anatomic gravity rates and the analgesic therapy was based on the World Health Organization's Analgesic Ladder. RESULTS: The main findings pointed to injuries in limbs, head, face and outer surface as the most frequent, and, in 85% of the cases, gravity was equal or lower than 3; As for analgesia, it was verified that 46;6% of the patients received dipyrone and paracetamol. Among the opioids, meperidine was used in 10.4% of the cases. CONCLUSION: The gravity of most injuries was equal or lower to 3, indicating injuries of light, moderate and serious gravity, located especially in four body regions; regarding analgesia, dipyrone was shown to be the most commonly-used drug and a low use of opioids was verified.

scholarly journals Morphology of <i>Emiliania huxleyi</i> coccoliths on the North West European shelf – is there an influence of carbonate chemistry?

2014 ◽  
Vol 11 (3) ◽  
pp. 4531-4561 ◽  
Author(s):  
J. R. Young ◽  
A. J. Poulton ◽  
T. Tyrrell
Keyword(s):  
Environmental Samples ◽  
Significant Variation ◽  
Emiliania Huxleyi ◽  
Morphometric Study ◽  
Saturation State ◽  
North West ◽  
The North ◽  
Microscope Images ◽  
Calcite Saturation ◽  
The Uk

Abstract. Within the context of the UK Ocean Acidification project, Emiliania huxleyi (type A) coccolith morphology was examined from samples collected during cruise D366. In particular, a morphometric study of coccolith size and degree of calcification was made on scanning electron microscope images of samples from shipboard CO2 perturbation experiments and from a set of environmental samples with significant variation in calcite saturation state (Ωcalcite). One bioassay in particular (E4 from the southern North Sea) yielded unambiguous results – in this bioassay exponential growth from a low level occurred with no artificial stimulation and coccosphere numbers increased ten-fold during the experiment. The samples with elevated CO2 saw significantly reduced coccolithophore growth. However, coccolithophore morphology was not significantly affected by the changing CO2 conditions even under the highest levels of perturbation (1000 μatm). Environmental samples similarly showed no correlation of coccolithophore morphology with calcite saturation state. Some variation in coccolith size and degree of calcification does occur but this seems to be predominantly due to genotypic differentiation between populations on the shelf and in the open ocean.

scholarly journals 'Greenfields' and 'Brownfields': automotive industrial development in the UK and in Portugal

Finisterra ◽  
2012 ◽  
Vol 31 (62) ◽  
Author(s):  
Andrew Pike ◽  
Mário Vale
Keyword(s):  
Industrial Policy ◽  
Automobile Industry ◽  
Industrial Development ◽  
Development Strategies ◽  
North West ◽  
Demonstration Effect ◽  
North East ◽  
The North ◽  
The Uk ◽  
The Impact

The industrial policy in the UK and in Portugal, as in most EU countries, seeks to attract new investment capacity, to create jobs and to promote the impact of the so-called "demonstration efect" of "greenfield" development strategies pursued in the new plants of inward investors on existing or "brownfield" plants. This industrial policy focus is particularly evident in the automobile industry.This paper compares the industrial policy oriented towards the automobile industry in the UK and in Portugal. Two recent "greenfield" investments are analised: Nissan in the North-East region (UK) and Ford/VW in the Setúbal Peninsula (Portugal), as well as three "brownfield" plants: Ford Halewood and GM Vauxhall Ellesmere Port in the North-West region (UK) and Renault in Setúbal (Portugal). The first part starts with a discussion of industrial policy in the automobile sector, the role of "greenfield" development strategies and the "demonstration effect" on "brownfield" plants. Then, the limits of new inward investment are pointed out, basically their problems and restrictions. Afterwards, the structural barriers to the "demonstration effect" within "brownfield" plants are outlined and some possabilities for alternative "brownfield" development strategies are presented.

scholarly journals La zone canadienne des 200 milles dans l’Atlantique, un exemple de la nouvelle géographie politique des océans

2005 ◽  
Vol 11 (2) ◽  
pp. 239-251 ◽  
Author(s):  
André-Louis Sanguin
Keyword(s):  
Surface Area ◽  
Political Geography ◽  
Law Of The Sea ◽  
The Political ◽  
North West ◽  
The Third ◽  
The North ◽  
The World ◽  
National Jurisdiction ◽  
Economic Zone

Following upon the Third Conference on the Law of the Sea begun in 1973, the principal maritime States of the world assumed exclusive national jurisdiction over a 12- mile zone extending from their coastlines and a 188-mile economic zone beyond territorial waters. Together they constitute the more familiarly referred to « 200-mile zone ». This new practice radically changed the political geography of the oceans, lessened the area within which the freedom of the seas exists, diminished by more than a third the surface area of the high seas and dealt a heavy blow to the fishing xpeditions of foreign trawlers. Canada is one of the principal users and one of the most vigourous defenders of the 200-mile principle for geographical reasons as much as for economic or political ones. The excessive exploitation of the seabed has been felt to be a threat for a portion of the population of the Eastern part of Canada. A firm policy criticized for being somewhat unilateral has enabled Canada to eliminate foreign fleets from its 200-mile zone. Over a period of 30 years the International Commission for North-West Atlantic Fisheries (ICNAF) attempted to introduce a positive international cooperation in order to eliminate the anarchic excessive exploitation. It was replaced in 1979 by the North-West Atlantic Fisheries Organization. A major dispute exists between France and Canada with respect to the delimitation of the economic zone of Saint-Pierre and Miquelon, French land since 1604. More generally, the question is posed as to how long the 200-mile principle will prevail in this new political geography of the oceans.

The World Economy

1997 ◽  
Vol 159 ◽  
pp. 28-56
Author(s):  
Julian Morgan ◽  
Nigel Pain ◽  
Florence Hubert
Keyword(s):  
World Trade ◽  
World Economy ◽  
Fiscal Consolidation ◽  
The Third ◽  
The North ◽  
External Demand ◽  
The Us ◽  
The World ◽  
World Economic ◽  
The Uk

There are now widespread signs that activity in the world economy has begun to recover steadily from the pause in growth apparent at the beginning of 1996. Output rose by 0.6 per cent in the North American economies in the third quarter of last year and by 0.8 per cent in Europe. Business and consumer sentiment has improved gradually in recent months in most of the major economies. We expect world economic growth to pick up further over the course of this year as the contractionary effects from the downturn in world trade and prolonged inventory adjustment come to an end and as the effects from a more relaxed monetary stance begin to outweigh those from ongoing fiscal consolidation. Recent currency movements should help to stimulate external demand in Germany, France and Japan, but may act to constrain growth within the UK, Italy and the US. For both this year and 1998 we expect growth of around 2½ per cent per annum in the OECD economies.

Roof of the World: Tibet, Pamirs

2013 ◽  
Author(s):  
Mike Searle
Keyword(s):  
Tibetan Plateau ◽  
High Elevation ◽  
Tien Shan ◽  
Palm Tree ◽  
The Tibetan Plateau ◽  
Wet Season ◽  
North West ◽  
Mountain Ranges ◽  
The North ◽  
The World

The Tibetan Plateau is by far the largest region of high elevation, averaging just above 5,000 metres above sea level, and the thickest crust, between 70 and 90 kilometres thick, anywhere in the world. This huge plateau region is very flat—lying in the internally drained parts of the Chang Tang in north and central Tibet, but in parts of the externally drained eastern Tibet, three or four mountain ranges larger and higher than the Alps rise above the frozen plateau. Some of the world’s largest and longest mountain ranges border the plateau, the ‘flaming mountains’ of the Tien Shan along the north-west, the Kun Lun along the north, the Longmen Shan in the east, and of course the mighty Himalaya forming the southern border of the plateau. The great trans-Himalayan mountain ranges of the Pamir and Karakoram are geologically part of the Asian plate and western Tibet but, as we have noted before, unlike Tibet, these ranges have incredibly high relief with 7- and 8-kilometre-high mountains and deeply eroded rivers and glacial valleys. The western part of the Tibetan Plateau is the highest, driest, and wildest area of Tibet. Here there is almost no rainfall and rivers that carry run-off from the bordering mountain ranges simply evaporate into saltpans or disappear underground. Rivers draining the Kun Lun flow north into the Takla Makan Desert, forming seasonal marshlands in the wet season and a dusty desert when the rivers run dry. The discovery of fossil tropical leaves, palm tree trunks, and even bones from miniature Miocene horses suggest that the climate may have been wetter in the past, but this is also dependent on the rise of the plateau. Exactly when Tibet rose to its present elevation is a matter of great debate. Nowadays the Indian Ocean monsoon winds sweep moisture-laden air over the Indian sub-continent during the summer months (late June–September). All the moisture is dumped as the summer monsoon, the torrential rains that sweep across India from south-east to north-west.

scholarly journals Building partnerships

2017 ◽  
Vol 1 (1) ◽  
pp. 1-8
Author(s):  
Richard Byrne
Keyword(s):  
Water Quality ◽  
Landscape Conservation ◽  
Sustainable Change ◽  
North West ◽  
The North ◽  
Quality Issue ◽  
The United Kingdom ◽  
Peat Deposits ◽  
The Uk ◽  
Water Quality Issue

Water is generally plentiful in the United Kingdom; however, there is an emerging water quality issue driven by agricultural intensification. Poor land management over generations has contributed to the degradation of upland peat deposits leading to discolouration of potable water and the loss of valuable habitats. Employing agri-environmental schemes operated by the UK Government and private Capital One water company in the North West of England is achieving water quality gains as well as landscape, conservation and habitat benefit at the same time as supporting tenant farm incomes. We describe the pressures on the uplands and how innovative partnerships are achieving sustainable change.

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