Central Slip Repair using Trans-articular K-wires: A Comparative Study.

Central slip disruption may lead to PIP joint dysfunction causing significant morbidity. Existing evidence for any specific surgical management of these injuries is limited but does favor early mobilization of the PIP joint. Aim: To assess the functional outcome in a cohort of patients undergoing central slip repair with internal K-wire proximal interphalangeal joint splinting and complete immobilization against those with external splinting only. Methods: A single center retrospective analysis of all patients that underwent operative central slip repair in our institution over a 5-year period. Data were collected via the HIPE database and clinical notes. Data relating to demographics as well as range of motion, total active motion {(TAM) (TAM%)} score, and hand therapy rehabilitation type were analyzed. Results: The study population was n = 44 patients. N = 33 patients were treated without a K-wire and n = 11 treated with a K-wire. There was a male predominance, 81.8% (n = 36). Mean age was 40.4 years. There was no significant difference in the mean TAM achieved at final measurement between the "no K-wire" and the "K-wire" treatment groups [no K-wire 202.1° (standard deviations (SD) 40.0) vs. K-wire 187.4° (SD 28.2), p = 0.208]. The "no K-wire group" achieved a mean TAM % of 78.0 (SD 11.4) and the "K-wire group" achieved a mean TAM % of 72.1 (SD 10.8); no statistically significant difference in mean scores was observed between groups. Conclusion: Our study has shown comparable functional outcomes between those having complete joint immobilization with internal K-wire splinting and those that are externally splinted only following central slip repair.

Factors associated with SARS-CoV-2 infection in patients attending an acute hospital ambulatory assessment unit.

To describe the factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in mild-to-moderate patients attending for assessment. This observational study was conducted in a Model 4 tertiary referral center in Ireland. All patients referred for SARS-CoV-2 assessment over a 4-week period were included. Patient demographics, presenting symptoms, comorbidities, medications, and outcomes (including length of stay, discharge, and mortality) were collected. Two hundred and seventy-nine patients were assessed. These patients were predominantly female (62%) with a median age of 50 years (SD 16.9). Nineteen (6.8%) patients had SARS-CoV-2 detected. Dysgeusia was associated with a 16-fold increased prediction of SARS-CoV-2 positivity (p = .001; OR, 16.8; 95% CI, 3.82-73.84). Thirteen patients with SARS-COV-2 detected (68.4%) were admitted, in contrast with 38.1% (99/260) of patients with SARS-CoV-2 non-detectable or not tested (p = .001). Female patients were more likely to be hospitalized (p = .01) as were current and ex-smokers (p = .05). We describe olfactory disturbance and fever as the main presenting features in SARS-CoV-2 infection. These patients are more likely to be hospitalized with increased length of stay; however, they make up a minority of the patients assessed. "Non-detectable" patients remain likely to require prolonged hospitalization. Knowledge of predictors of hospitalization in a "non-detectable" cohort will aid future planning and discussion of patient assessment in a SARS-CoV-2 era.

Epidemiology and impact of Neospora caninum infection in three Queensland tropical dairy herds.

This study investigated the epidemiology of Neospora caninum in three tropical dairy herds in North Queensland, Australia. All animals in the herds were bled, and the sera were tested by ELISA for N. caninum antibodies. Herd records were examined, and the number of calves carried to term and the number of abortions which occurred over the lifetime of each animal were recorded to determine the abortion rate for each animal. Pedigrees were constructed for two of the herds to investigate whether vertical transmission was occurring. The seroprevalence of N. caninum ranged from 23% to 34%. The abortion rate in seropositive animals was significantly (p < 0.001) higher than in seronegative animals in all three herds (12-20.1% cf. 3.6-7%). Overall, the probability of a calf being seropositive was 3.5 times higher when the dam was also seropositive than when the dam was seronegative. Subsequent selective breeding employed by one herd reduced the N. caninum seroprevalence from 23% to 5% over a 9-year period. This study shows that N. caninum infection is prevalent in North Queensland dairy cattle, and both post-natal infection and vertical transmission are common.

An ELISA to Detect Serum Antibodies to the Salivary Gland Toxin of Ixodes holocyclus Neumann in Dogs and Rodents.

The Ixodes holocyclus tick causes paralysis in up to 10,000 companion and domestic animals each year in Australia. Treatment requires the removal of the parasite and the administration of a commercial tick antiserum that is prepared from hyperimmune dogs. Each batch of this serum is initially tested for toxin-neutralising potency in a mouse bioassay that is expensive, time consuming, and subjective. With the aim of developing a rapid in vitro assay to replace the bioassay, we used a partially purified antigen prepared from I. holocyclus salivary glands to develop an ELISA to detect toxin-reactive antibodies in hyperimmune dog sera. The optimised ELISA reliably detected antibodies reactive to I. holocyclus salivary gland antigens. Parallel testing of sera with a negative control antigen prepared from the salivary glands of the nontoxic tick Rhipicephalus (Boophilus) microplus provided further evidence that we were detecting toxin-specific antibodies in the assay. Using the ELISA, we could also detect antibodies induced in rats after experimental infestation with I. holocyclus. This assay shows promise as an alternative means of assessing the potency of batches of hyperimmune dog serum and to screen for toxin-reactive monoclonal antibodies produced from immunised rodents.

Path changes in the movement of English Premier League soccer players.

AIM: Traditional time-motion analysis methods have analysed broad locomotive movements and distances covered by players in different speed ranges. It is necessary to consider path changes made during movements in order to understand the agility requirements of soccer. The purpose of the current investigation was to describe the path changes performed in English FA Premier League soccer. METHODS: The Prozone® path change identification system identified three different types of path change within accurate timed player co-ordinate data gathered by the Prozone3® player tracking system. Data for 90 minute plus performances of 180 different players were included in the current investigation. RESULTS: The players performed 38±15 path changes of 45° to 135° to the left, 35.5±14.3 path changes of 45o to 135° to the right and 20.2±90 path changes of 135o or greater. Positional role had a significant influence on the number of each type of path change performed with midfielders performing more of each path change type than defenders and forwards. There was also a significant difference in the number of each type of path change performed between different 15 minute periods of the match with more of each type being performed in the first 15 minutes and fewer of each type being performed between 60 minutes and 75 minutes than during any other period. CONCLUSION: These results have implications for agility requirements of soccer match play that conditioning coaches should be aware of.

Tick paralysis in Australia caused by Ixodes holocyclus Neumann.

Ticks are obligate haematophagous ectoparasites of various animals, including humans, and are abundant in temperate and tropical zones around the world. They are the most important vectors for the pathogens causing disease in livestock and second only to mosquitoes as vectors of pathogens causing human disease. Ticks are formidable arachnids, capable of not only transmitting the pathogens involved in some infectious diseases but also of inducing allergies and causing toxicoses and paralysis, with possible fatal outcomes for the host. This review focuses on tick paralysis, the role of the Australian paralysis tick Ixodes holocyclus, and the role of toxin molecules from this species in causing paralysis in the host.

Current and emerging techniques in gastrointestinal imaging.

This review is devoted to current and emerging techniques in gastrointestinal (GI) imaging. It is divided into three sections focusing on areas that are both interesting and challenging: imaging of the small bowel and appendix, imaging of the colon and rectum and finally liver and pancreas in the upper abdomen. The first section covers cross-sectional imaging of the small bowel using the techniques of multidetector computed tomography (MDCT) (including CT enterography) and magnetic resonance imaging (MRI). The evaluation of mesenteric ischemia and GI tract bleeding using MDCT angiography is also reviewed. Current imaging practice in the evaluation of appendix is also reviewed and illustrated. The second section reviews CT and MR colonography and imaging of the rectum. It describes CT virtual colonoscopy (CTVC) with emphasis on the advantages and disadvantages of the technique with discussion of the role of CTVC in screening. The intriguing topic of MR colonography (MRC) is also reviewed. Imaging of the rectum with emphasis on imaging of rectal cancer is described with the roles of CT, MR, endoluminal ultrasound and positron emission tomography scanning discussed. The final section reviews current and emerging techniques in liver imaging with the role of ultrasound including contrast ultrasound, MDCT and MR (including contrast agents) discussed. The new developments and applications of imaging of pancreatic disease are discussed with emphasis on the role of MDCT and MRI with gadolinium. This review highlights the current role and advancement of imaging techniques with new diagnostic and prognostic information pertinent to gastrointestinal disease continuing to emerge.

Genitourinary imaging: current and emerging applications.

This review discusses the current and emerging techniques in urinary tract imaging. Recent technical advances and novel discoveries make this an exciting but challenging time for urinary tract imaging. The first section describes the imaging of the adrenal gland which has made great strides in the last decade, the current major adrenal imaging modalities as well as new applications are discussed with particular attention to the role of imaging in the incidentally detected adrenal lesion. In the second section the role of ultrasound, computed tomography (CT) and magnetic resonance (MR) in evaluation of the renal tract are discussed with the new technical advances leading to earlier detection and characterization of renal lesions. Complementary to this is the emerging role of CT and MR urography in assessment of the urinary tract and bladder in contrast to the demise of plain film studies/intravenous urography. The role of CT angiography in assessment of the renal vasculature is also discussed. The third section discusses the role of prostate imaging in the diagnosis, staging and management of prostate cancer. Transrectal ultrasonography, can be used to guide biopsy, CT is frequently used in staging, with bone scintigraphy and positron emission tomography having roles in advanced disease. Currently, all imaging modalities, especially MR are evolving to improve disease detection and staging. The final section discusses the recently encountered adverse reaction of nephrogenic systemic fibrosis in patients post gadolinium-enhanced MRI and how to help prevent this adverse reaction.

Fatal encephalitozoonosis in two koalas.

Two young koalas from a fauna park, recently out of the pouch and approximately 6 months old, were found dead with no previous clinical signs or gross lesions. On histopathological examination, large numbers of spores consistent with a microsporidian organism were present intracellularly within the small intestinal mucosa. Electron microscopy and polymerase chain reaction studies (sequencing the 5' end of the SSU RNA gene) identified the organism as Encephalitozoon intestinalis with 100% homology with those of previously reported human isolates. This is believed to be the first report of this organism in a marsupial.

Analysis of age, stature, body mass, BMI and quality of elite soccer players from 4 European Leagues.

AIM: The aim was to identify which league (English Premier League, Spanish La Liga Division, Italian Serie A and German Bundesliga) contained the highest quality players and whether differences in age, stature, body mass and BMI existed between the different positions in different leagues. METHODS: Data were collected concerning 2,085 professional soccer players playing in these 4 leagues during the 2001-2002 season. Player quality was determined by the leagues' number of international players and their nations' FIFA World Ranking (FWR). RESULTS: The La Liga Division contained the highest quality players (mean FWR) (11.5+/-13.8), followed by the Serie A (13.3+/-21.3), the Premier League (30.6+/-27.3) and the Bundesliga (30.7+/-27.1), respectively. Also, differences were found between the age, stature, body mass and BMI of players in different positions and in the different leagues. Age had a significant influence on position with goalkeepers (years) (27.4+/-5.3) being older than midfielders (26.2+/-4.3) and forwards (25.8+/-4.2) and defenders (26.8+/-4.3) being older than forwards. Players from the Bundesliga had the greatest stature (m) (1.83+/-0.06), body mass (kg) (77.5+/-6.4) and BMI (kg x m(-2)) (23.2+/-1.1) of the 4 leagues. In reflection, La Liga's players had the shortest stature (1.80+/-0.06) and the Serie A players had the least body mass (74.3+/-5.4) and BMI (22.8+/-1.1). CONCLUSIONS: The differences discovered suggest either differences in playing style and physical demands of the different leagues, different physical conditioning methods or, alternatively, that there are desirable characteristics of players with teams in all 4 leagues seeking such players.

Pathology associated with endogenous development of haematozoa in birds from southeast Queensland.

A study was undertaken on the pathology and associated schizont morphology of apicomplexan species of avian haematozoa. Some 32 birds from the families Artamidae, Meliphagidae, Oriolidae, Podargidae, Columbidae, Alcedinidae and Psittacidae were identified as having schizonts in various tissues. Based on blood stages observed, the probable relationship to tissue stages was considered. The majority of schizonts were referable to the genera Leucocytozoon and Haemoproteus. The comparative morphology of tissue stages previously described in the literature is discussed and the involvement of protozoa other than haematozoa considered. The naturally occurring infections in wild birds described in this study represent previously unreported data on the life-cycle stages involved. Some schizonts measured up to 640 microm. While pathological changes in some hosts were noticeable, in others no significant findings were observed. The role of endogenous stages in avian morbidity is discussed briefly.

Phylogenetic relationships of Hepatozoon (Haemogregarina) boigae, Hepatozoon sp., Haemogregarina clelandi and Haemoproteus chelodina from Australian reptiles to other Apicomplexa based on cladistic analyses of ultrastructural and life-cycle characters.

The phylogeny of representative haemozoan species of the phylum Apicomplexa was reconstructed by cladistic analyses of ultrastructural and life-cycle characteristics. The analysis incorporated 4 apicomplexans previously not included in phylogenetic reconstructions: Haemogregarina clelandi from the Brisbane River tortoise (Emydura signata), Hepatozoon sp. from the slaty grey snake (Stegonotus cucullatus), Hepatozoon (Haemogregarina) boigae from the brown tree snake (Boiga irregularis), and Haemoproteus chelodina from the saw-shelled tortoise (Elseya latisternum). There was no apparent correlation between parasite phylogeny and that of their vertebrate hosts, but there appeared to be some relationship between parasites and their intermediate hosts, suggestive of parasite/vector co-evolution.

Ultrastructure of Hepatozoon boigae (Mackerras, 1961) nov. comb. from brown tree snakes, Boiga irregularis, from northern Australia.

Intraerythrocytic bodies identified as haemogregarine gamonts were found in 29% of 97 brown tree snakes (Boiga irregularis) examined during a haematological survey of reptiles in Australasia during 1994-1998. The morphological characteristics of the parasites were consistent with those of Haemogregarina boigae Mackerras, 1961, although the gamonts were slightly larger and lacked red caps but contained distinctive polar grey capsules. Gamonts did not distend host cells but laterally displaced their nuclei. They were contained within parasitophorous vacuoles and possessed typical apicomplexan organelles, including a conoid, polar rings, rhoptries and micronemes. Schizonts producing up to 30 merozoites were detected in endothelial cells of the lungs of 11 snakes. The absence of erythrocytic schizogony suggests the parasites belong to the genus Hepatozoon. Electron microscopy also revealed the presence of curious encapsulated organisms in degenerating erythrocytes. These stages did not possess apical complex organelles and were surrounded by thick walls containing circumferential junctions and interposed strips reminiscent of oocyst sutures.

Toxoplasmosis in Indo-Pacific humpbacked dolphins (Sousa chinensis), from Queensland.

OBJECTIVE: To describe the clinical signs, gross pathology, serology, bacteriology, histopathology, electron microscopy and immunohistochemistry findings associated with toxoplasmosis in four Indo-Pacific humpbacked dolphins (Sousa chinensis) that stranded in Queensland in 2000 and 2001. DESIGN: Clinical assessment, gross necropsy, and laboratory examinations. PROCEDURE: Necropsies were performed on four S. chinensis to determine cause of death. Laboratory tests including serology, bacteriology, histopathology and transmission electron microscopy were done on the four dolphins. Immunohistochemistry was done on the brain, heart, liver, lung, spleen and adrenal gland from various dolphins to detect Toxoplasma gondii antigens. RESULTS: Necropsies showed all of four S. chinensis that stranded in Queensland in 2000 and 2001 had evidence of predatory shark attack and three were extremely emaciated. Histopathological examinations showed all four dolphins had toxoplasmosis with tissue cysts resembling T. gondii in the brain. Tachyzoite stages of T. gondii were detected in the lungs, heart, liver, spleen and adrenal gland, variously of all four dolphins. Electron microscopy studies and immunohistochemistry confirmed the tissues cysts were those of T. gondii. All four dolphins also had intercurrent disease including pneumonia, three had peritonitis and one had pancreatitis. CONCLUSION: Four S. chinensis necropsied in Queensland in 2000 and 2001 were found to be infected with toxoplasmosis. It is uncertain how these dolphins became infected and further studies are needed to determine how S. chinensis acquire toxoplasmosis. All four dolphins stranded after periods of heavy rainfall, and coastal freshwater runoff may be a risk factor for T. gondii infection in S. chinensis. This disease should be of concern to wildlife managers since S. chinensis is a rare species and its numbers appear to be declining.