Detection and quantification by molecular techniques of early infection by Lawsonia intracellularis in suckling piglets.

BACKGROUND: Lawsonia intracellularis is the causative agent of Porcine Proliferative Enteropathy (PPE), one of the most prevalent pig enteric diseases worldwide, but with sparse information about early infections in suckling piglets in the epidemiology of PPE. With that aim, this study evaluates the prevalence of L. intracellularis in 3-week-old piglets by analysing ileal digesta content and mucosal scrapings from 383 pigs from 16 farms (aprox., 25 pigs/batch) by real-time qPCR and droplet digital PCR (ddPCR). RESULTS: Forty-nine samples yielded a qPCR positive result. Eleven samples from eight farms were confirmed as positive with concentrations of L. intracellularis from 3.5 log10 to 4.5 log10 bacteria/g of sample. Another 16 samples, eight farms, were classified as low positive (2.07-2.38 log10 bacteria/g) and 22 provided an uncertain result. Finally, 334 samples tested negative for L. intracellularis. At batch level, half of the farms included in the study had at least one positive sample and in 10 farms (62.5%) there was at least one low positive sample. The ddPCR was run in 50 of the 383 samples based on their PCR output (including low positive, uncertain and negative samples). Correlation analyses revealed a strong association between qPCR and the ddPCR results (ρ = 0.75; p < 0.001). The ddPCR allowed us to detect and confirm a positive result in the 19 samples classified as uncertain by the qPCR and detect L. intracellularis in 8 of 15 negatives by qPCR. CONCLUSIONS: The results of the study demonstrate that a number of piglets are already infected with L. intracellularis during the suckling period evidencing early infection in certain animals, adding information of PPE epidemiology and opening new research topics such as sow-piglet transmission. Study results also evidence the usefulness of a combination of qPCR and ddPCR to improve qPCR sensitivity but assuring high specificity.

Monitoring of porcine circovirus type 2 infection through air and surface samples in vaccinated and unvaccinated fattening farms.

Air and surfaces of swine farms are the two alternative samples to obtain information about the health status of the herd. The aim of this study was to assess air and surface sampling for the detection of porcine circovirus type 2 (PCV2) in vaccinated and unvaccinated fattening farms, studying the relationship between the viral load in these samples with the viremia at herd level. Three swine fattening batches (one unvaccinated; two vaccinated) were monitored at 10, 12, 14, 16 and 18 weeks old; at each stage, blood, air and different surfaces were sampled and analysed by qPCR. In all herds, PCV2 was detected in all types of samples. Whenever viremia was detected, PCV2 was also detected in air and surface samples, even in those cases with a low estimated prevalence (1.6%); moreover, in two out of the three herds, PCV2 was detected in air and surface samples earlier than in the blood of the sampled population. In addition, a good correlation between the viremia of pig population and the PCV2 load in air and surface samples was found in both cases (τ = 0.672 and 0.746, respectively; p <0.05). These results show that air and surface samples could be useful tools to monitor PCV2 infection, being suitable for detecting the virus in cases of low prevalence and even before pigs develop viremia; therefore, these sampling techniques would speed up the implementation of the required measures to prevent productive and economic losses due to PCV2 infection.

Long term results of lower limb posttraumatic acute bone defects treated with masquelet technique.

INTRODUCTION: Several alternatives are now available when treating posttraumatic acute bone defects. Masquelet's technique represents a safe procedure to treat lower limb open fractures associated with significant bone defects and allows surgeons to try to reduce complications incidence. MATERIAL AND METHODS: Retrospective study based on patients´ record files and images (2015-2017). Twelve patients suffering acute bone defect, treated using Masquelet technique, were evaluated. A total of ten patients were finally included after exclusion criteria were applied. RESULTS: Average time from injury to first stage surgery was 11 days. Free flaps were required in three cases (two latissimus dorsi and one anterolateral thigh flap). Time to second stage surgery was 115 days on average. As bone graft, reaming irrigation-aspiration system was associated to this technique. Consolidation was achieved in all patients but one after an average time of 8.4 months. There was only one case of limb shortening of 20 mm. There was no case of nonunion or infection, and patients could perform daily basic activities independently. VAS mean score was one point one year after final surgery. CONCLUSIONS: Masquelet's technique achieves encouraging results when treating lower limb acute bone defects. Using this technique, surgeons could decrease infection incidence in open fractures with severe bone loss. On the other hand, it is a two-stage surgery process, which makes the process longer.

Environmental distribution of Porcine Circovirus Type 2 (PCV2) in swine herds with natural infection.

Porcine circovirus type 2 (PCV2) is the aetiological agent of PCV2-Systemic Disease (PCV2-SD) and PCV2-Subclinical Infection (PCV2-SI). PCV2 is highly resistant to environmental conditions, being able to remain in the farm environment and thus represent a risk for infection maintenance. The aim of this study was to identify, under field conditions, the possible critical points in the environment of non-vaccinated farrow-to-weaning swine farms where PCV2 could accumulate and persist. For that, environmental samples from five swine farms with PCV2-SD or PCV2-SI were taken and analysed by qPCR, including different farm areas, farm personnel and management implements. PCV2 DNA was detected in the environment of all farms (42.9% of positive samples). Overall, the PCV2-SD herd seemed to present more positive samples and higher viral loads than the PCV2-SI herds. At individual farm level, weaning areas appeared to be the most contaminated facilities. In addition, PCV2 was found at high levels in most samples from farm workers, especially work boots, suggesting that they may play a role in within-farm transmission. In addition, PCV2 was detected in areas without animals the like warehouses, offices and farm perimeter. Therefore, this study is helpful to improve measures to reduce within-farm PCV2 dissemination.

Simultaneous juxta-epiphyseal proximal phalanx fracture with flexor tendon entrapment in a child: a case report and review of literature.

Juxta-epiphyseal/Salter-Harris fractures are the most common hand fractures in children and the proximal phalanx is involved in most cases. In the absence of soft-tissue interposition, these growth plate injuries are simple to reduce and are stable. However, in some cases, flexor tendon entrapment could be present. We report on an 11-year-old girl who sustained a fall onto her outstretched hand with subsequent injuries in her long, ring, and small fingers. Plain radiographs showed a severely displaced juxta-epiphyseal proximal phalanx fracture in her ring finger associated with mildly displaced juxta-epiphyseal proximal phalanx fractures of the long and small fingers. Fracture reduction could not be achieved after a closed reduction attempt. An open reduction and stabilization using Kirschner wires was performed in the fourth and fifth fingers, because of entrapment of the flexor digitorum profundus tendon. Excellent functional as well as radiological outcomes were achieved. These types of injuries are very uncommon and a high index of suspicion on the basis of clinical as well as radiological findings is needed to make an early diagnosis and for adequate treatment. Multiple proximal phalangeal fractures could be associated with the simultaneous entrapment of flexor tendons in different fingers as in our case; this is important to keep in mind as it is useful when planning the definitive surgical treatment and doing so will have a positive impact on the final functional as well as radiological outcomes.

Complications and associated risk factors at screw removal in slipped capital femoral epiphysis treated by cannulated stainless steel screws.

PURPOSE: The aim of our study is to report our complication rate and analyze the associated risk factors when removing cannulated stainless steel screws for SCFE fixation. METHODS: This was a multicenter retrospective study of patients who underwent removal of cannulated stainless steel screws after a mean time of 2.03 years of implantation. Thirty-two patients were included (38 hips) with a mean of 13.7 years of age during screw removal surgery. The mean post-removal follow up time was 1.6 years. In all cases the removal of screws was done systematically. Demographic data, possible risk factors related to removal failure, as well as post-removal complications such as post-removal fractures, infections and scar issues were recorded. RESULTS: A removal failure rate of 15.79 % (6/38) was found. The removal surgical time was longer than the initial fixation time but without statistical significance (70.78 vs 61.84 m, p = 0.196). However, the duration of screw implantation (r (2): 7.09; IC: 1.12-13.06) and screw head bony coverage (r (2): 21.32; IC: 5.58-37.06) were both related to this prolonged time. Multivariant analysis revealed that a fully threaded cannulated screw had the lowest removal failure risk (OR: 0.3; IC: 0.14-0.61). There were no postremoval complications recorded. CONCLUSIONS: We recommend to use full threaded cannulated stainless steel screws and to perform the procedure as soon as the physis are closed to decrease the surgical time. It is a safe procedure based on a low rate of complications such as post-removal fractures, infection and scar issues.

Comparison between external fixators and fixed-angle volar-locking plates in the treatment of distal radius fractures.

Distal radius fractures are a common disorder in industrialized nations associated with osteoporosis, with a reported incidence of two fractures per thousand patients per year. We performed a retrospective study comparing two sets of 40 patients, with fracture of the distal radius treated with Penning external fixator, compared to 40 patients treated with fixed-angle volar-locking plate (Plate Depuy ® DVR), with the objective of finding differences between both treatment methods in anatomical values, functional outcomes and complication rates. All fractures were classified according to the AO classification. Postero-anterior and lateral radiographs of the wrist were taken after fracture, after surgery and at 6 months after surgery. We also assessed functional outcome. Minimum follow up was of 10 months. We compared complications between both groups. In the group of patients treated with fixed-angle volar-locked plate, radiological results are found to be closer to the anatomical references. Final outcomes revealed similar functional scores between both groups. The complications rate was statistically higher in the group of patients who underwent external fixation. In the fixed-angle volar-locked plate group, most of complications were related to patient discomfort due to the volar-locking plate.