Long-Term Outcomes of Birmingham Hip Resurfacing Arthroplasty: A Systematic Review of Independent Series with At Least 10 Years of Follow-up.

Background: Hip resurfacing arthroplasty (HRA) provides an attractive alternative to total hip arthroplasty (THA) for the management of osteoarthritis in younger, more active patients; however, concerns persist over complications specific to HRA. The aims of this systematic review were to assess the documented long-term survival rates of the metal-on-metal BIRMINGHAM HIP Resurfacing System at a follow-up of at least 10 years and to analyze the functional outcomes and cause of failures. Methods: A systematic review was undertaken of all published cohort studies available in the MEDLINE, Cochrane, Embase, and PubMed research databases up to December 2021, as recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extraction was focused on survival rates, causes of failure, and functional outcomes. Survival estimates at 10 years were pooled in a meta-analysis, with each series weighted by its variance. Causes of failure were presented as a percentage of the pooled revisions. Results: A total of 11 studies were identified, encompassing 3,129 cases. Across the 9 studies that had reported a mean follow-up, the mean follow-up was 11.7 years (range, 9.55 to 13.7 years). We found a pooled 10-year survival rate of 95.5% (95% confidence interval, 93.4% to 97.1%). There were 149 revisions among the studies (range, 4 to 38 revisions per study), a rate of 4.8% of the total procedures performed. The 2 main causes of revision were aseptic loosening (20.1% of revisions) and adverse reactions to metal debris (20.1%). There were no revisions for dislocation. Of the studies that reported preoperative functional scores, all reported significant improvement in mean scores postoperatively except for 1 study in which the mean Tegner activity score did not significantly improve. Conclusions: When performed for appropriate indications, patients undergoing an HRA with use of the BIRMINGHAM HIP Resurfacing System can expect good implant survivorship at 10 years with acceptable functional results and low rates of dislocation and infection. This systematic review, however, confirms concerns regarding adverse reactions to metal debris as a leading cause of revision. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Lanthanide complexes of DOTA-nitroxide conjugates for redox imaging: spectroelectrochemistry, CEST, relaxivity, and cytotoxicity.

The lanthanide(iii) complexes (Gd, Eu, Dy, and Yb) of DOTA tris(amide) and bis(amide) derivatives (L1 and L2) featuring one redox active TEMPO arm were prepared. Ligand L2 harbours an alkyne fragment for further functionalization. The X-ray crystal structure of ligand L2 in complexation with Na+ was solved. The complexes showed in their CV one oxidation wave (0.26-0. 34 V vs. Fc+/Fc) due to an oxoammonium/nitroxide redox couple and a broad reduction corresponding to the nitroxide/hydroxylamine system. The Eu complexes demonstrated the presence of one water molecule in their coordination sphere. The nitroxide complexes were characterized by EPR spectroscopy, showing the typical 3-line pattern in the high temperature regime, which is quenched upon the addition of ascorbate (reduction into hydroxylamine). In their nitroxide form, the complexes show essentially no CEST peak. Conversely, the reduced complexes demonstrate a 12% CEST peak at 51 ppm, corresponding to the metal bound water molecule. Fast exchange precluded the CEST activity for the amide protons. All the complexes proved to be essentially non-toxic for M21 cells at concentrations up to 50 µM.

Structural and spectroscopic investigations of nine-coordinate redox active lanthanide complexes with a pincer O,N,O ligand.

The lanthanide complexes EuL3, GdL3, YbL3 and LuL3 of the N,N'-bis(2-hydroxy-di-3,5-tert-butylphenyl)amine were prepared. The X-Ray crystal structures of GdL3 and LuL3 demonstrated a nine-coordinate sphere with three ligand molecules under their anionic diamagnetic form (Cat-N-BQ)-. The complexes showed three oxidation events (Eox11/2 = 0.15-0.16 V, E1/22 = 0.51-55 V, and E1/23 = 0.75-0.78 V vs. Fc+/Fc) via cyclic voltammetry, corresponding to the successive oxidation of the aminophenolate moeities to iminosemiquinone species. The complexes GdL3 and YbL3 were characterized by EPR spectroscopy, allowing for the determination of the zero field splitting (ZFS) parameters in the first case. The monocations (LnL3)+ and monoanions (LnL3)- were electrochemically generated (Ln = Eu, Gd, Yb, Lu), as well as the dications YbL32+ and LuL32+. The spins are antiferromagnetically exchange coupled in the diradical species LuL32+ (|D| = 260 MHz, E = 0). All the complexes (incl. neutral) possess a strong absorption band in the NIR region (730-840 nm, ε > 19 mM-1 cm-1) corresponding to ligand-based transitions.

Mid- to long-term function and implant survival of ACL reconstruction and medial Oxford UKR.

PURPOSE: The purpose of this study was to describe mid- to long-term outcomes of anterior cruciate ligament (ACL) reconstruction with simultaneous or staged medial unicompartmental knee replacement (UKR), and compare outcomes between (1) young patients aged younger than 55 at surgery and those older, (2) those with long-term follow-up greater than 10 years, (3) cemented and cementless UKR, and (4) compare outcomes to those with an intact ACL. PATIENTS AND METHODS: We identified knees with staged or simultaneous ACL reconstruction and medial UKR from a prospectively followed designer UKR cohort, and describe mean Oxford Knee Score (OKS), mean Tegner activity score and Kaplan-Meier survival estimates. We matched these knees to ACL-intact knees. RESULTS: Seventy-six consecutive UKR with staged or simultaneous ACL reconstruction were identified with mean six-year follow-up (range 1-15). There was significant improvement in OKS and Tegner score with surgery. At most recent follow-up, OKS was 41.0 (range 11 to 48), and Tegner score 3.6 (0 to 8). There were three revisions occurring at a mean of five years post-operatively. The five-, 10- and 15-year survival estimates were 97% (95% confidence interval [CI] 93-100), 92% (83-100), and 92% (83-100). There was no difference in functional scores or implant survival in young patients, those with long-term follow-up (>10 years), those with cementless fixation, or when compared to ACL intact knees. CONCLUSION: These results demonstrate excellent mid- to long-term function and survival of selected patients who have undergone ACL reconstruction and medial UKR. Their outcome was similar to those with intact ACLs.

Functional Outcome and Revision Rate Are Independent of Limb Alignment Following Oxford Medial Unicompartmental Knee Replacement.

BACKGROUND: There is controversy about optimal limb alignment following knee replacement. An aim of using Oxford medial unicompartmental knee replacement (UKR) implants is to accurately restore normal ligament tension in the knee, thereby restoring normal kinematics. This return to normal tension typically results in a return to prearthritic alignment, which is frequently varus. The aim of this study was to investigate the relationship between postoperative limb alignment and postoperative patient-reported outcome and implant revision rate. METHODS: We used a consecutive cohort of 891 knees with cemented Oxford medial UKR implants with a mean 10-year follow-up and recorded alignment. We grouped knees according to postoperative mechanical alignment as marked varus (estimated at 10°), mild varus (estimated at 5°), neutral, and valgus. The mean Oxford Knee Score (OKS) was calculated at 5 and 10 years postoperatively. Revision risk was assessed by survival analysis and component-time incidence rates. RESULTS: Postoperatively, 67 (8%) of the 891 knees were in marked varus; 308 (35%), in mild varus; 508 (57%), in neutral; and 8 (1%), in valgus. The valgus group (8 knees) was too small for further analysis. The mean OKS (and standard deviation [SD]) at 10 years postoperatively was 41.7 ± 7 for marked varus, 40.5 ± 8 for mild varus, and 39.4 ± 9 for neutral alignment (p = 0.28). At 10 years, 92%, 85%, and 76% achieved a good or excellent OKS outcome, respectively (p = 0.02). Twelve-year survival rates were 93.3% for marked varus, 93.2% for mild varus, and 93.6% for neutral alignment, respectively (p = 0.53). Revision incidence rates per 100 component-years were 0.49 (95% confidence interval [CI], 0.2 to 1.5), 0.36 (95% CI, 0.2 to 0.7), and 0.54 (95% CI, 0.4 to 0.8), respectively, and were not significantly different (p = 0.53). CONCLUSIONS: Marked postoperative varus mechanical alignment of an estimated 10° was present in 8%, and mild varus of about 5° was present in 35%. Increasing varus alignment was associated with an increasing percentage of good or excellent OKS outcomes, but otherwise there were no significant differences between alignment groups in patient-reported outcome or revision rate. These data support the standard operative technique for the Oxford UKR, which aims to restore ligament tension and therefore prearthritic alignment rather than neutral mechanical alignment. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Genetic variation at the Th2 immune gene IL13 is associated with IgE-mediated paediatric food allergy.

BACKGROUND: Food allergies pose a considerable world-wide public health burden with incidence as high as one in ten in 12-month-old infants. Few food allergy genetic risk variants have yet been identified. The Th2 immune gene IL13 is a highly plausible genetic candidate as it is central to the initiation of IgE class switching in B cells. OBJECTIVE: Here, we sought to investigate whether genetic polymorphisms at IL13 are associated with the development of challenge-proven IgE-mediated food allergy. METHOD: We genotyped nine IL13 "tag" single nucleotide polymorphisms (tag SNPs) in 367 challenge-proven food allergic cases, 199 food-sensitized tolerant cases and 156 non-food allergic controls from the HealthNuts study. 12-month-old infants were phenotyped using open oral food challenges. SNPs were tested using Cochran-Mantel-Haenszel test adjusted for ancestry strata. A replication study was conducted in an independent, co-located sample of four paediatric cohorts consisting of 203 food allergic cases and 330 non-food allergic controls. Replication sample phenotypes were defined by clinical history of reactivity, 95% PPV or challenge, and IL13 genotyping was performed. RESULTS: IL13 rs1295686 was associated with challenge-proven food allergy in the discovery sample (P=.003; OR=1.75; CI=1.20-2.53). This association was also detected in the replication sample (P=.03, OR=1.37, CI=1.03-1.82) and further supported by a meta-analysis (P=.0006, OR=1.50). However, we cannot rule out an association with food sensitization. Carriage of the rs1295686 variant A allele was also associated with elevated total plasma IgE. CONCLUSIONS AND CLINICAL RELAVANCE: We show for the first time, in two independent cohorts, that IL13 polymorphism rs1295686 (in complete linkage disequilibrium with functional variant rs20541) is associated with challenge-proven food allergy.

The skin barrier function gene SPINK5 is associated with challenge-proven IgE-mediated food allergy in infants.

BACKGROUND: A defective skin barrier is hypothesized to be an important route of sensitization to dietary antigens and may lead to food allergy in some children. Missense mutations in the serine peptidase inhibitor Kazal type 5 (SPINK5) skin barrier gene have previously been associated with allergic conditions. OBJECTIVE: To determine whether genetic variants in and around SPINK5 are associated with IgE-mediated food allergy. METHOD: We genotyped 71 "tag" single nucleotide polymorphisms (tag-SNPs) within a region spanning ~263 kb including SPINK5 (~61 kb) in n=722 (n=367 food-allergic, n=199 food-sensitized-tolerant and n=156 non-food-allergic controls) 12-month-old infants (discovery sample) phenotyped for food allergy with the gold standard oral food challenge. Transepidermal water loss (TEWL) measures were collected at 12 months from a subset (n=150) of these individuals. SNPs were tested for association with food allergy using the Cochran-Mantel-Haenszel test adjusting for ancestry strata. Association analyses were replicated in an independent sample group derived from four paediatric cohorts, total n=533 (n=203 food-allergic, n=330 non-food-allergic), mean age 2.5 years, with food allergy defined by either clinical history of reactivity, 95% positive predictive value (PPV) or challenge, corrected for ancestry by principal components. RESULTS: SPINK5 variant rs9325071 (A⟶G) was associated with challenge-proven food allergy in the discovery sample (P=.001, OR=2.95, CI=1.49-5.83). This association was further supported by replication (P=.007, OR=1.58, CI=1.13-2.20) and by meta-analysis (P=.0004, OR=1.65). Variant rs9325071 is associated with decreased SPINK5 gene expression in the skin in publicly available genotype-tissue expression data, and we generated preliminary evidence for association of this SNP with elevated TEWL also. CONCLUSIONS: We report, for the first time, association between SPINK5 variant rs9325071 and challenge-proven IgE-mediated food allergy.

Vitamin D insufficiency in the first 6 months of infancy and challenge-proven IgE-mediated food allergy at 1 year of age: a case-cohort study.

BACKGROUND: Ecological evidence suggests vitamin D insufficiency (VDI) due to lower ambient ultraviolet radiation (UVR) exposure may be a risk factor for IgE-mediated food allergy. However, there are no studies relating directly measured VDI during early infancy to subsequent challenge-proven food allergy. OBJECTIVE: To prospectively investigate the association between VDI during infancy and challenge-proven food allergy at 1 year. METHODS: In a birth cohort (n = 1074), we used a case-cohort design to compare 25-hydroxyvitamin D3 (25(OH)D3 ) levels among infants with food allergy vs a random subcohort (n = 274). The primary exposures were VDI (25(OH)D3 <50 nM) at birth and 6 months of age. Ambient UVR and time in the sun were combined to estimate UVR exposure dose. IgE-mediated food allergy status at 1 year was determined by formal challenge. Binomial regression was used to examine associations between VDI, UVR exposure dose and food allergy and investigate potential confounding. RESULTS: Within the random subcohort, VDI was present in 45% (105/233) of newborns and 24% (55/227) of infants at 6 months. Food allergy prevalence at 1 year was 7.7% (61/786), and 6.5% (53/808) were egg-allergic. There was no evidence of an association between VDI at either birth (aRR 1.25, 95% CI 0.70-2.22) or 6 months (aRR 0.93, 95% CI 0.41-2.14) and food allergy at 1 year. CONCLUSIONS: There was no evidence that VDI during the first 6 months of infancy is a risk factor for food allergy at 1 year of age. These findings primarily relate to egg allergy, and larger studies are required.

A redox active switch for lanthanide luminescence in phenolate complexes.

The reversible oxidation of coordinated phenolates into phenoxyl radicals results in a dramatic quenching (>95%) of the luminescence of the f metal ion.

Silicon carbide--a high-transparency nonlinear material for THz applications.

Optical properties of 4H-SiC were measured using time-domain and Fourier transform spectroscopy in the range of 0.1-20 THz. A high-transparency region was found between <0.1-10 THz. Based on the obtained data and published results, the refractive indices for o-wave and e-wave were approximated in the form of Sellmeier equations for the entire transparency range. Phase matched frequency conversion was found to be possible at wavelengths from the visible through the mid-IR and further into the far-IR (THz) region beyond 17 µm. Extremely low absorption coefficient, high damage threshold, and the possibility of phase matching make this material highly suited for high power THz optics and generation.

Prospective image planning in radiation therapy for optimization of image quality and reduction of patient dose.

INTRODUCTION: CT simulation data in image-guided radiation therapy (IGRT) provides patient-specific subject contrast. This information can be exploited to establish, a priori, a suitable imaging goal and to select patient-specific imaging acquisition parameters that optimize the similarity between reference and daily set-up images and reduce imaging dose. This study aims to describe and clinically validate a computerized algorithm designed to provide such optimization. MATERIAL AND METHODS: An image planning system (IPS) was developed to assist in planar kV imaging technique selection for radiation therapy. The system's patient-specific image quality and dose reduction capabilities were validated herein. Anthropomorphic phantom and clinical data were acquired. Mutual information (MI) was used to compare simulated and measured images in both phantom and clinical tests. Variations in contrast resolution resulting from imaging panel underexposure, saturation and a contrast plateau were investigated. For evaluation of patient-specific imaging dose reduction, the IPS was used to modify acquisition settings for six patients. RESULTS: Phantom data confirmed the IPS's predictive capability regarding image contrast. Measured and simulated images showed similar progressions from under-exposure, image quality peak, and loss of contrast due to detector saturation. Clinical data demonstrated that contrast resolution and imaging dose could be prospectively improved without loss of image contrast. The algorithm reduced imaging dose by an average of 47%, and a maximum of 80%. CONCLUSIONS: Loss of image contrast resulting from under-exposure or over-exposure, as well as a contrast plateau can be predicted by use of a prospective image planning algorithm. Image acquisition parameters can be predicted that reduce patient dose without loss of useful contrast.

Terahertz time-domain spectroscopy for textile identification.

A range of natural and artificial textiles are examined using terahertz time-domain spectroscopy. Different types of textiles are shown to have different terahertz optical properties, which may be employed for textile identification and to combat textile counterfeiting.

Development and certification of green tea-containing standard reference materials.

A suite of three green tea-containing Standard Reference Materials (SRMs) has been issued by the National Institute of Standards and Technology (NIST): SRM 3254 Camellia sinensis (Green Tea) Leaves, SRM 3255 Camellia sinensis (Green Tea) Extract, and SRM 3256 Green Tea-Containing Solid Oral Dosage Form. The materials are characterized for catechins, xanthine alkaloids, theanine, and toxic elements. As many as five methods were used in assigning certified and reference values to the constituents, with measurements carried out at NIST and at collaborating laboratories. The materials are intended for use in the development and validation of new analytical methods, and for use as control materials as a component in the support of claims of metrological traceability.

SU-E-T-400: SBRT Dose Verification Using Monte Carlo Simulation.

PURPOSE: To verify the SBRT plans on CMS Xio treatment planning system using the Monte Carlo simulation and investigate the related issues. METHODS: The SBRT plans with 6 MV were created on CMS Xio treatment planning system with superposition algorithm. The same patient's CT, beam geometry and MUs were used in the Monte Carlo simulation (MC) on MCSIM. MCSIM is an EGS4-based MC dose calculation system for photon and electron beams. The Monte Carlo plans were compared with the Xio plans to verify Xio superposition algorithm for SBRT. The electron disequilibrium was particularly investigated by comparing the DVHs for a 2-mm thick peel of the GTV. The beam energy was changed from 6 MV to 10 MV for MC to test energy effect on SBRT dosimetry. RESULTS: Six SBRT lung plans created on Xio and delivered on Varian 21 EX linac were included in this study. The tumor GTV ranged from 1.4 cc to 11 cc and the dose ranged from 1950 cGy to 5400 cGy. The comparisons were made in terms of DVHs, mean doses, minimal doses, and maximal doses for GTV. The results showed all the dose values of Xio plans agreed with MC to within 2% with only two exceptions of 3% and 5%. The dose distribution in the peel of GTV followed the same pattern as the whole GTV. This indicated the Xio superposition algorithm has well accounted for electron disequilibrium. The 10-MV beams had both hot and cold spots from DVH comparison. This may be due to the large build-up region for high energy beams. CONCLUSIONS: The Xio superposition algorithm has adequately accounted for electron disequilibrium and can perform accurate dose calculation for SBRT. Compared to high energy beams, 6 MV is preferable in terms of the GTV coverage and dose homogeneity.

SU-E-J-178: Development of Image Planning System for Radiation Therapy.

PURPOSE: The constraints required for patient imaging dose received during image-guided radiotherapy differ from those applied in the diagnostic realm. Wide latitude in applied dose can be justified if it results in useful improvement in image quality. Currently, image acquisition parameters are chosen via broad categorizations in patient anatomy and imaging goal. Herein, we describe the development and early benchmarking of a patient-specific image planning system that is capable of predetermining the optimal acquisition parameters for a given level of patient dose and imaging goal. METHODS: An algorithm was written in Matlab that performed a divergent ray-trace through a 3D CT data set and impinges on a flat imaging receptor. Energy-specific attenuation through each voxel of the CT data set is calculated to derive a net transmitted intensity. The detector response as a function of beam quality and exposure was measured and integrated into the algorithm. It is primarily this feature that distinguishes this from a traditional digitally reconstructed radiograph. Verification data was collected using a flat panel imager mounted onto a linear accelerator gantry and a lung phantom with an embedded nodule. Loss of object detectability was evaluated by measuring the visible diameter of the phantom nodule. RESULTS: There is qualitative agreement between simulated and measured images in terms of contrast and object detectability. The simulation algorithm predicts both under-exposure and saturation of the detector over a range of beam qualities (80 keV to 120keV) and exposure levels. Object detectability erodes predictably above 60 mAs for at 80keV and above 15mAs for 120 keV for both simulated and measured images. Quantitative accuracy is currently limited by lack of beam heterogeneity, which will be added in further work. CONCLUSIONS: The feasibility and qualitative accuracy of an image planning system has been established.

SU-E-T-13: Comparison of Dose Rates with and without Gold Backing of USC #9 Radioactive Eye Plaque Using MCNP5.

PURPOSE: To show the effect of gold backing on dose rates for the USC #9 radioactive eye plaque. METHODS: An I125 source (IsoAid model IAI-125A) and gold backing was modeled using MCNP5 Monte Carlo code. A single iodine seed was simulated with and without gold backing. Dose rates were calculated in two orthogonal planes. Dose calculation points were structured in two orthogonal planes that bisect the center of the source. A 2×2 cm matrix of spherical points of radius 0.2 mm was created in a water phantom of 10 cm radius. 0.2 billion particle histories were tracked. Dose differences with and without the gold backing were analyzed using Matlab. RESULTS: The gold backing produced a 3% increase in the dose rate near the source surface (<1mm) relative to that without the backing. This was presumably caused by fluorescent photons from the gold. At distances between 1 and 2 cm, the gold backing reduced the dose rate by up to 12%, which we attribute to a lack of scatter resulting from the attenuation from the gold. Dose differences were most pronounced in the radial direction near the source center but off axis. The dose decreased by 25%, 65% and 81% at 1, 2, and 3 mm off axis at a distance of 1 mm from the source surface. These effects were less pronounced in the perpendicular dimension near the source tip, where maximum dose decreases of 2% were noted. CONCLUSIONS: I 125 sources embedded directly into gold troughs display dose differences of 2 - 90%, relative to doses without the gold backing. This is relevant for certain types of plaques used in treatment of ocular melanoma. Large dose reductions can be observed and may have implications for scleral dose reduction.

Characterization of the antibody response in birds following infection with wild-type and attenuated strains of Eimeria tenella and Eimeria necatrix.

Live vaccines containing attenuated parasite strains are increasingly used to control chicken coccidiosis. In this paper antibody responses elicited by infections with wild-type and attenuated strains of Eimeria tenella and Eimeria necatrix were characterized by immunoblotting and ELISA with homologous and heterologous antisera. Few differences between antisera from birds infected with wild and attenuated strains of E. tenella were evident in immunoblots conducted with merozoite antigen preparations from both E. tenella strains, however the reactivity of sera raised in birds infected with the wild-type strain was noticeably more intense. In ELISAs conducted with merozoite antigen preparations, antisera from birds infected with the wild-type strains of E. tenella and E. necatrix consistently produced a significantly higher (P<0.05) antibody response than antisera from birds infected with the attenuated strains. Likewise, avidity ELISAs conducted with the E. tenella strains demonstrated that antibodies in birds infected with the wild-type strain were of significantly higher avidity (P<0.05) than antibodies in birds infected with the attenuated strain. The differences in the antibody responses are probably due to changes in the attenuated strain as a result of selection for precocious development and the less severe tissue damage and inflammation of the intestine resulting from infection with the attenuated strain.

Systemic sclerosis as a model of chronic rejection in facial composite tissue transplantation.

INTRODUCTION: Chronic rejection remains a potential significant long-term problem of facial allograft transplantation. Scleroderma parallels chronic rejection in terms of its immunological pathophysiology and its histopathological processes. Through the analysis of facial changes in scleroderma we demonstrate how chronic facial allograft rejection may present and progress. METHODS: 129 consecutive patients with a clinical diagnosis of scleroderma were recruited into the study. Static facial disease assessment was carried out through the analysis of digital photographs. Facial motion dysfunction was assessed using a modified House-Brackmann Grading Scale and an established maximal static response assay. Psychological evaluation comprised the Derriford Appearance Scale short-form (DAS), the Noticeability and Worry score and the Hospital Anxiety and Depression Scale (HADS). RESULTS: Static disease severity as measured using an observer-rated disfigurement scale revealed all grades of disease in the scleroderma cohort - from mild through to severe. Significant positive correlations were seen between observer rated disfigurement and DAS24, Noticeability and Worry scores. No significant relationship could be seen between the indices of facial motion impairment and psychological scores. CONCLUSIONS: Progressive facial deterioration seen over time in scleroderma provides a comprehensive spectrum of static and dynamic facial changes which may be encountered in chronic facial graft rejection. This study provides valuable insight into the potentially significant long-term sequelae of allogenic reconstructive transplantation.

Real-time polymerase chain reaction (PCR) assays for the specific detection and quantification of seven Eimeria species that cause coccidiosis in chickens.

Coccidiosis of chickens is an economically important disease caused by infection with species of Eimeria. The oocysts of some of the seven recognized species are difficult to distinguish morphologically and for this reason diagnostic laboratories are increasingly utilizing DNA-based technologies for the specific identification of Eimeria. The real-time PCR provides both sensitivity and speed for the analysis of DNA samples, and the approach has the capability of quantifying DNA. Together with a protocol for the extraction of DNA directly from faecal samples, real-time PCR assays have been established for the detection and quantification of seven species of Eimeria that infect chickens in Australia. The assays target one genetic marker, the second internal transcribed spacer of nuclear ribosomal DNA (ITS-2), use TaqMan MGB technology with species-specific probes, and can be multiplexed in pairs such that the seven species of Eimeria can be screened in four reaction tubes. A test screen of commercial flocks identified more Eimeria-infected chickens than were detected by coproscopic examination for oocysts. These molecular assays can also be used for the quality control of mixed-species vaccines. The ability to multiplex the assays makes them particularly practical for screening samples from chickens with mixed-species infections where the relative abundance of each Eimeria species present is required.