Search

The prevalence of hoof lesions and lameness in 4899 heifers and cows was determined at claw trimming one time in a cross-sectional study on 101 Swedish dairy farms, 1996-1998. The percentage of affected animals was 41% for heel-horn erosion, 30% for sole haemorrhages, 27% for erosive dermatitis, 21% for abnormal claw shape, 14% for white-line haemorrhages, 8.8% for white-line fissures, 8.6% for sole ulcers, 3.3% for double soles, 2.3% for verrucose dermatitis, and 1.8% for interdigital hyperplasia (IH). Seventy-two percent of all animals had at least one hoof lesion. The prevalence of lameness was 5.1%; most hoof lesions did not cause lameness. Differences between herds were substantial; the herd-specific, animal-level prevalence of lesions ranged from 25 to 98% and of lameness from 0 to 33%. Sole haemorrhages were found in all herds. The proportion of variance at the between-herd level was particularly high for heel-horn erosion (62%) and abnormal claw shape (54%). Strong correlations between lesions were found within hooves (and animals), e.g. for heel-horn erosion and dermatitis (Spearman's rank correlation, r(s)=0.36 and 0.37, respectively) and for sole and white-line haemorrhages (r(s)=0.25 and 0.28). Most hoof lesions affected hind and front hooves bilaterally, whereas the correlation between hind and front hooves generally was lower. Herds that ranked high for prevalence of sole ulcer also ranked high for sole haemorrhages and for abnormal claw shape and herds that ranked high for dermatitis also ranked high for heel-horn erosion, verrucose dermatitis and IH. Abnormal claw shape was strongly associated with sole ulcer (r(s)=0.41 at cow level)-suggesting the importance of maintaining a correct claw shape for the prevention of hoof-horn lesions.

Three hundred and seventy-five Saudi Arabian patients with type 2 diabetes were consecutively examined for peripheral neuropathy, foot ulcers, amputations and hypertension. All the 46-69-year-old patients (n = 212) were compared to a corresponding Swedish group seen by the same physician using identical approach and definitions. Vibration sensitivity was examined using a tuning fork. Pin prick sensitivity using a needle on the plantar and dorsal aspects of the foot. Distal neuropathy was defined as complete absence of vibration and/or pin prick sensitivity in an extremity. With a diabetes duration of 10 or more years the prevalence of neuropathy among the 375 Saudi Arabians was 38% (95% confidence intervals 30-45); hypertension 19% (13-25) current and past ulcers 4.7% (1.3-8); amputations below ankle 3.4% (0.5-6). In the selected 46-69-year-old group prevalence of hypertension (17%), ulcers (2.3%) and amputation (1%) was significantly lower in the Saudi Arabian than in the Swedish patients. The frequencies reported here are the first from the Arab Peninsula. The Saudi Arabian patients with type 2 diabetes have the same prevalence of distal neuropathy as other ethnic groups. A low prevalence of hypertension is consistent with findings in expatriate and indigenous Arab groups with type 2 diabetes. The low occurrence of ulcers and amputations may be explained by different styles of footwear.

A method previously developed for classification of broiler foot health status was used in order to estimate the prevalence of foot-pad dermatitis in Swedish turkey poults. Data on foot health were collected from 53 commercial turkey flocks at slaughter. The producers were asked to fill in a questionnaire on rearing conditions and equipment for every flock. Lesions were very commonly observed, only 2% of the feet were classified as being without lesions, 78% had mild lesions (discoloration, erosions), and 20% had severe lesions (ulcers). There was a significant (p < 0.01) effect of litter material on the presence of severe foot-pad dermatitis, flocks reared on straw showing higher prevalence than flocks reared on wood shavings. There was also a significant (p < 0.001) effect of the type of water system, severe foot-pad dermatitis being more common in flocks reared in houses equipped with bell drinkers compared with flocks reared with small cups. The addition of extra litter during the rearing period resulted in significantly (p < 0.01) lower prevalence of lesions compared with flocks where no extra litter had been added.

Objective: To study the prevalence, demography, perceived aetiology, level of care, treatment and nursing care of patients treated for leg and foot ulcers., Design: Prospective survey of leg and foot ulcer patients, using a structured questionnaire consisting of 20 questions directed at nurses and doctors in 193 units, including both primary health care and hospital., Setting: South Stockholm Medical Area, Stockholm, Sweden., Patients: Two hundred and ninety-four patients with leg and foot ulcers were identified during the six-week study period., Main Outcome Measures: Demographic data of population, prevalence of leg and foot ulcers, level of care, economic aspects, treatment of ulcers, level of compression, characteristics of the ulcers, pain and analgesics., Results: With a population of 241,804 in the area, the prevalence of leg and foot ulcer was 0.12%. The majority of patients (92%) were older than 65 years of age, median age 79.2 years. The commonest cause of leg ulceration, as estimated by the staff, was venous insufficiency (42%). The majority of patients were treated within the primary health care system, and only a minority were treated in hospital. Many different local wound dressings were used (n = 51). The majority of dressing changes were performed by auxiliary nurses (54%). Compression was practised in 86% of all cases diagnosed as venous ulcers. Pain was reported by staff in 47% of all patients with venous ulcers. No pain relief was given to 29% of all these cases.

Five thousand one hundred and forty questionnaires concerning leg ulcers were sent to a randomly selected population aged 65 years and older in Gothenburg in April 1989. The response rate was 89%. Ninety-seven individuals answered affirmatively, that they had leg ulcers, which corresponds to a prevalence of 2.15 +/- 0.42 per cent. These 97 individuals and the same number of controls were asked to come for a medical examination with tests of the peripheral circulation and an interview. Seventy-five (of the 97) were examined. Thirty-five had leg or foot ulcers caused by vascular insufficiency and/or diabetes and the true prevalence was estimated to be 1.02 +/- 0.29 per cent.

By means of a questionnaire sent to all medical units in Malmö, including primary care, homes for the elderly, and industrial health clinics, 275 patients with leg and foot ulcers were identified. With a population of 232,908 in Malmö, this corresponds to a prevalence of 0.12%, which is lower than reported by others. Since the response rate was high (88% total, Primary Care: 100%), the prevalence of 0.12% is, however, believed to be real and might be explained by the urban area investigated, with easy access to care and proximity to one somatic hospital. 50% of the patients with leg and foot ulcers were treated in Primary Care, and 30% of the leg ulcer patients were treated at the Department of Dermatology. 88% of leg and foot ulcer patients were over 75 years of age. Median age was 79.5 years, with 80 for women and 76.5 for men. In Primary Care the median age was 82. There was a predominance of women in the study population with an overall sex ratio of 3:1. A higher proportion of patients living alone was found in Primary Care. The etiology of the ulcers was considered to be "unknown" or "other" or else no statement was given in 36% of the leg ulcer- and 22% of the foot ulcer patients. This might reflect an overall uncertainty about the underlying etiological cause. Medially and laterally located leg ulcers were reported equally often, but there was also a great proportion of wholly or partially circumferential ulcers. 76% of the foot ulcers were located on the toes.(ABSTRACT TRUNCATED AT 250 WORDS)