Qualitative Magnetic Resonance Imaging Assessment of the Semimembranosus Tendon in Patients with Medial Meniscal Tears.

BACKGROUND: To determine if there is an association between semimembranosus tendinosis and medial meniscal tears using MRI. METHODS: A retrospective review of knee 3T MRI scans was performed to determine the presence or absence of medial meniscal tears in patients with semimembranosus tendinosis. All studies were interpreted by two musculoskeletal radiologists. Univariate association for the presence of semimembranosus tendinosis and medial meniscal tears was performed with a Chi-square test followed by logistic regression modelling among statistically significant associations. RESULTS: A total of 150 knee MRI scans were reviewed (age 32.8 ± 7.1 years; 70 females). Semimembranosus tendinosis was present in 66 knees (44%) in the patient population. Semimembranosus tendinosis was present in 81% of patients with meniscal tears versus 36% of patients without meniscal tears (p < 0.0001). This association remained statistically significant when adjusted for age and sex with an adjusted odds ratio of 7.0 (p < 0.0003). Models adjusted for the above covariates and containing the interaction term produced an adjusted odds ratio of 13.0 (p < 0.0001) in men, while in women this association was non-significant with an adjusted odds ratio of 2.0 (p = 0.42). CONCLUSIONS: Subjects with semimembranosus tendinosis were seven times more likely to have medial meniscal tears even when adjusting for sex and age. This could help guide the appropriate postmeniscal repair rehabilitation protocol.

Human exposures to Brucella canis from a pregnant dog during an international flight: Public health risks, diagnostic challenges and future considerations.

AIMS: This report documents the exposure of passengers and crew of a commercial international flight to the zoonotic pathogen Brucella canis after an infected dog aborted in the passenger cabin of the aircraft. This case demonstrates the challenges associated with brucellosis screening and the risks that airline personnel, airport employees and travellers face when animals with unrecognized zoonotic infections are transported. METHODS/RESULTS: The public health investigation of this case was conducted by the Centers for Disease Control, the Illinois Department of Health and the Illinois Department of Agriculture, in collaboration with a local veterinary clinic and several academic and federal diagnostic laboratories. It included an extensive diagnostic evaluation of the dam and aborted foetuses to confirm a diagnosis of canine brucellosis. Passengers, airline personnel and staff from the veterinary clinic where the dogs were treated underwent risk assessments, and clinic staff also received detailed guidance regarding infection prevention practices. CONCLUSIONS: Animal shelters and breeding programs are recommended to screen dogs routinely for brucellosis, but it is not unusual for domestic or imported animals to have unknown health histories, including the dog's brucellosis status, at the time of purchase, adoption, or re-homing. Testing recommendations and requirements vary by state, making it challenging for state public health and animal health agencies to monitor and respond appropriately. This case highlights the importance of Brucella spp. screening in sexually intact dogs prior to breeding, purchase, or domestic or international transportation of the dogs. The transportation of pregnant dogs may present a previously unrecognized public health threat in addition to contributing to unnecessary stress and health risks for pregnant animals.

Rabies in a Dog Imported from Azerbaijan - Pennsylvania, 2021.

On June 16, 2021, rabies virus infection was confirmed in a dog included in a shipment of rescue animals imported into the United States from Azerbaijan. A multistate investigation was conducted to prevent secondary rabies cases, avoid reintroduction of a dog-maintained rabies virus variant (DMRVV), identify persons who might have been exposed and would be recommended to receive rabies postexposure prophylaxis, and investigate the cause of importation control failures. Results of a prospective serologic monitoring (PSM) protocol suggested that seven of 32 (22%) animals from the same shipment as the dog with confirmed rabies virus infection and who had available titer results after rabies vaccine booster had not been adequately vaccinated against rabies before importation. A requirement for rabies vaccination certificates alone will not adequately identify improper vaccination practices or fraudulent paperwork and are insufficient as a stand-alone rabies importation prevention measure. Serologic titers before importation would mitigate the risk for importing DMRVV.

Chondrolysis of the glenohumeral joint after infusion of bupivacaine through an intra-articular pain pump catheter: a report of 18 cases.

PURPOSE: To report on our experience of patients who received infusion of bupivacaine with epinephrine after arthroscopic glenoid labral repair surgery and in whom glenohumeral joint chondrolysis subsequently developed, as well as to determine the incidence of such chondrolysis in our surgeons' patient populations. METHODS: A retrospective chart review of 18 patients diagnosed with chondrolysis was carried out. All patients were from 2 experienced orthopaedic surgeons' practices. Details of their clinical course were obtained and summarized. These data were compared with all other arthroscopies completed by the 2 surgeons to determine the incidence of chondrolysis. RESULTS: All 18 patients diagnosed with glenohumeral joint chondrolysis received postoperative infusion of bupivacaine with epinephrine through an intra-articular pain pump catheter (IAPPC). None of the patients received thermal energy as part of their procedure. None of the patients had evidence of glenohumeral joint infection, although an extensive workup was frequently undertaken. Clinically, patients presented with a stiff, painful shoulder. Examination showed decreased range of motion of the affected shoulder. Radiographs and magnetic resonance imaging showed joint space narrowing, as well as subchondral sclerosis and cyst formation. Of the 18 patients, 14 have since undergone repeat arthroscopic procedures, and 5 have received a humeral head-resurfacing operation. Within the same time period, there were 113 arthroscopies, with 45 pain pumps used. Chondrolysis developed in 16 of 32 patients with high-flow IAPPCs and 2 of 12 patients with low-flow IAPPCs (1 patient's IAPPC flow rate was not documented). CONCLUSIONS: Although we cannot establish a causal link, the development of glenohumeral chondrolysis may be related to the intra-articular infusion of bupivacaine with epinephrine postoperatively. We thus caution against the use of IAPPCs. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Outbreak of rabbit hemorrhagic disease in domestic lagomorphs.

Rabbit hemorrhagic disease (RHD) was diagnosed in domestic lagomorphs on a rabbit farm in Illinois. Clinical signs of RHD in affected rabbits included signs of depression, anorexia, fever, paddling, convulsions, and sudden death. Findings of necropsies and histologic evaluations of specimens of liver and spleen were indicative of RHD. In liver specimens obtained from dead rabbits, RHD viral antigen was detected via hemagglutination assay and viral antigen-detection ELISA. The source of the outbreak was traced to a rabbitry in Utah. As the disease spread, the outbreak involved rabbits in various regions of the United States; > 4,800 rabbits were euthanatized and buried as a result of the depopulation effort in several states. The economic impact of the disease can be considerable; if the disease is suspected, it is imperative that the appropriate state or federal veterinarian's office be contacted immediately.

Fabric structures for mass shelter in disaster areas

The purpose of the proposed work is to advance the state of the art of providing shelter for large populations struck by disasters. The shelter will be safe (from health hazards), stable (resist external forces), self-contained (does not require additional support), light weight and easily packaged, stored, transported, erected and relocated. To be effective it should be readily available (within 48 hours), affordable to large communities and relief agencies, and usable on a self help basis for extended periods. the shelter will house individual and social activities and provide protection from the elements. Facilitate some continuity of economic/productive/administrative and educational enterprises, and protect equipment and material from deterioration. The shelter also will facilitate essential life support and security for its inhabitants