Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of 2 different LCP systems.

OBJECTIVE: This study compares the mechanical stability and surgical usability of 2 locking plate systems (Kyon ALPS-20 and Synthes PIP-LCP system) for arthrodesis of the equine proximal interphalangeal joint (PIJ). MATERIAL AND METHODS: The experimental ex vivo study included 6 pairs of cadaver distal limbs (n = 12). All specimens were derived from Warmblood horses of various ages that were euthanized for non-orthopedic reasons. Of the 12 limbs collected, 3 left and 3 right distal limb specimens were randomly assigned to each system for implantation. Two abaxial 4.5-mm cortical screws were inserted transarticularly in all cases. Both systems were implanted according to the manufacturer's instructions with the plates placed centrally between the 2 transarticular screws. The ALPS-20 systems were implanted using Kyon B-6.4-mm monocortical locking screws in all positions. The LCP systems were implanted axially using 2 Synthes 5-mm locking screws in the proximal and distal positions, with a standard 4.5-mm cortical screw inserted in the middle position. All constructs underwent CT-scans after implantation and biomechanical testing to detect implant deformation. Uniaxial mechanical loading was applied via a servo-hydraulic test system at a test speed of 50 mm/s, up to a maximum displacement of 80 mm. The resulting load-displacement curves were used to calculate yield point, stiffness, and maximum force for each construct. The measured values were evaluated for statistical significance (p < 0.05) between the 2 plate systems via one-factor ANOVA (Tukey test). The statistical power was verified for yield force, stiffness, and maximum load. RESULTS: No statistically significant differences between the 2 preparation groups were calculated across all of the measured parameters (p > 0.05). The ALPS system implants showed no signs of deformation, either in the plates or the screws. In contrast, the LCP demonstrated visible deformation, which had already occurred at the time of implantation from the tightening of the middle screw, as well as during the subsequent testing of the implants. After biomechanical testing, deformations ranging between 3.1° and 7.0° were measured in 4 LCPs. A total implant failure was observed for 2 LCPs. CONCLUSION AND CLINICAL RELEVANCE: Both systems demonstrated comparable mechanical properties in the present study's ex vivo test model for equine PIJ arthrodesis. As such, the Kyon ALPS-20 may be a good alternative to the Synthes LCP for equine PIJ arthrodesis.

Observational study of nasopharyngeal carriage of Neisseria meningitidis in applicants to a military academy in the Russian Federation.

OBJECTIVE: To determine the carriage and the serogroup distribution of Neisseria meningitidis in military academy applicants in the Russian Federation. DESIGN: This was a prospective, observational study of adults aged >18years from a military academy; applicants who had samples taken on arrival (Day 1), and applicants who had samples taken after passing exams (Day 30) and 60days after arrival. N. meningitidis serogrouping was determined by slide agglutination tests of isolates and real-time PCR. RESULTS: Samples were provided by 671 applicants on Day 1 and 261 applicants on Day 30, with 232 of these also providing samples on Day 60. N. meningitidis was detected in 16.2% of samples from Day 1, 7.7% of samples from Day 30 and 15.9% of samples from Day 60. Serogroup composition was most diverse at Day 1, with serogroups B and W dominant (40% [17/43 isolates] and 9% [4/43], respectively; 30% [13/43] ungroupable); by Day 60, there was a low diversity, with 58% (14/24 isolates) serogroup W. CONCLUSIONS: While carriage of N. meningitidis in this study appeared stable, there was an increase in carriers of serogroup W in this population. Given recent increases in outbreaks attributed to serogroup W, further monitoring may be considered.

Safety and Immunogenicity of Two Doses of a Quadrivalent Meningococcal Polysaccharide Diphtheria Toxoid Conjugate Vaccine in Indian and Russian Children Aged 9 to 17 Months.

OBJECTIVE: Evaluation of tolerability, safety and immunogenicity of a two-dose series of a quadrivalent meningococcal polysaccharide diptheria toxoid conjugate (ACYW-D) vaccine in Indian and Russian infants/toddlers. DESIGN: Open-label, single-arm, phase III multi-national trial. STUDY PARTICIPANTS: 300 children aged 9-17 months, previously unvaccinated against meningococcal disease from four sites each in India (n=200) and the Russian Federation (n=100). INTERVENTION: Two 0.5 mL doses of ACYW-D by intramuscular injection, 3-6 months apart. MAIN OUTCOME MEASURES: Meningococcal antibody titers to serogroups A, C, W-135 and Y, determined using a serum bactericidal assay in the presence of human complement before vaccination and 28 days after the second vaccination. Titers ≥1:8 against either/all of the A, C, W-135 or Y were considered sero-protective. RESULTS: After dose 2, 95.7-99.5% and 92.9-99.0% of infants/toddlers achieved seroprotection across the four serogroups in India and the Russian Federation, respectively. No immediate adverse events were reported after any dose of ACYW-D. Solicited reactions were reported in 49.2% of participants, and were mainly of Grade 1 severity, and resolved within three days. Unsolicited adverse events were reported in 19.1% of infants: one event (Grade 3 diarrhea, resolving within one day) was considered related to study vaccine. No non-serious adverse events led to premature withdrawal from the study. Four serious adverse events were reported; none were considered related to study vaccine. No deaths occurred during the study. CONCLUSIONS: A two-dose series of ACYW-D vaccine in Indian and Russian children (9-17 month) was well-tolerated with no safety concerns, and induced robust bactericidal antibody responses against the meningococcal serogroups contained in the vaccine.