GIANT RED KIDNEY WORM (DIOCTOPHYMA RENALE) INFECTION IN PUPPIES LESS THAN FOUR MONTHS OF AGE FROM NORTHERN CANADA.

In this article, we present 2 case reports of puppies less than 4 mo of age at the time of infection with the nematode known as giant red kidney worm (Diotophyma renale). The first puppy was prepared for an ovariohysterectomy that evolved into an exploratory laparotomy. An inflamed omentum was observed, and D. renale infection was suspected due to the puppies' place of origin. The algorithm developed by the Ontario Society for the Prevention of Cruelty to Animals for the diagnosis and treatment of D. renale infections in dogs was followed. Both puppies had a history of origin from northern Manitoba, Canada. Due to the puppies' ages, the authors suspect that the transmission of infection for both puppies could be transmammary, transplacental, or ingestion of paratenic hosts or that these cases challenge what is thought to be the current prepatent period. In addition, D. renale infections in dogs, especially from northern communities, could be common.

Validation of a Surgical Objective Structured Clinical Examination (S-OSCE) Using Convergent, Divergent, And Trainee-Based Assessments of Fidelity.

OBJECTIVE: Describe the validation of a surgical objective structured clinical examination (S-OSCE) for the purpose of competency assessment based on the Royal College of Canada's Can-MEDS framework. DESIGN: A surgical OSCE was developed to evaluate the management of common orthopedic surgical problems. The scores derived from this S-OSCE were compared to Ottawa Surgical Competency Operating Room Evaluation (O-SCORE), a validated entrustability assessment, to establish convergent validity. The S-OSCE scores were compared to Orthopedic In-Training Examination (OITE) scores to evaluate divergent validity. Resident evaluations of the clinical encounter with a standardized patient and the operative procedure were scored on a 10-point Likert scale for fidelity. SETTING: A tertiary level academic teaching hospital. PARTICIPANTS: 21 postgraduate year 2 to 5 trainees of a 5-year Canadian orthopedic residency program creating 160 operative case performances for review. RESULTS: There were 5 S-OSCE days, over a 4-year period (2016-2019) encompassing a variety of surgical procedures. Performance on the S-OSCE correlated strongly with the O-SCORE (Pearson correlation coefficient 0.88), and a linear regression analysis correlated moderately with year of training (R²â€¯= 0.5345). The Pearson correlation coefficient between the S-OSCE and OITE scores was 0.57. There was a significant increase in the average OITE score after the introduction of the surgical OSCE. Resident fidelity ratings were available from 16 residents encompassing 8 different surgical cases. The average score for the overall simulation (8.0±1.6) was significantly higher than the cadaveric surgical simulation (6.5 ± 0.8) (p < 0.001) CONCLUSIONS: The S-OSCE scores correlate strongly with an established form of assessment demonstrating convergent validity. The correlation between the S-OSCE and OITE scores was less, demonstrating divergent validity. Although residents rank the overall simulation highly, the fidelity of the cadaveric simulation may need improvement. Administration of a surgical OSCE can be used to evaluate preoperative and intraoperative decision making and complement other forms of assessment.

Giant Red Kidney Worm (Dioctophyma renale) Screening and Treatment Protocol and Aberrant Worm Migration In Dogs From Ontario and Manitoba, Canada.

The life cycle of Dioctophyma renale involves an intermediate host (oligochaete), a paratenic hosts (fish and frogs), and a definitive host (mustelids and canids). Dogs are at risk of infection with D. renale when they consume paratenic hosts infected with the larval form of D. renale. Water containing the oligochaete intermediate host cannot be disregarded as another source of infection. Infections occur mainly in the right kidney, but worms have also been found in the abdominal cavity as well as other organs. Most dogs appear asymptomatic and infections are usually noted as incidental findings on necropsy. Recently, the Ontario Society for the Prevention of Cruelty to Animals (SPCA) and Humane Society conducted transports of dogs located in northern remote communities. In 2016, some female dogs were found to be infected with D. renale upon ovariohysterectomy. In response to this discovery, we developed a screening protocol to screen for D. renale infections. In 2018, a total of 130 intact dogs were transferred from 2 northern communities in the provinces of Ontario and Manitoba. A prevalence of 7.94% (95% confidence interval 3.87-14.11%) was found from dogs from the northern communities. The screening protocol we developed provides a method of screening for dogs that are transported from communities that could be at risk of infection with D. renale.

Higher periprosthetic fracture rate associated with use of modern uncemented stems compared to cemented stems in femoral neck fractures.

INTRODUCTION:: Hemiarthroplasty is the preferred treatment for displaced femoral neck fractures in elderly patients. Recently, short tapered-wedge cementless stems have increasingly been used in this population. However, historic data has consistently shown higher rates of periprosthetic fracture with uncemented stems in hip fracture patients. This study aims to evaluate the rate of periprosthetic fracture requiring re-operation and all-cause mortality between cemented and uncemented femoral stem designs including more recent short tapered-wedge cementless stems in hip fracture patients. METHODS:: A retrospective chart and radiographic review of patients received bipolar hemiarthroplasty for femoral neck fractures from 2010-2016. Patients biologically (age ≥ 65 years) or physiologically (American Society of Anesthesiologists (ASA) class ≥ 3) elderly were eligible. The uncemented group was subdivided into tapered-wedge stems (a broach only system) and reamed uncemented stems. The primary outcome was periprosthetic fracture requiring re-operation. RESULTS:: We included 657 patients in total, with 296 and 361 patients in the uncemented and cemented stem groups respectively. In the uncemented group there were 197 tapered-wedge and 99 reamed uncemented stems. There was a significantly higher rate of periprosthetic fracture requiring re-operation in the uncemented group (3.0% vs. 0.6%) ( p ≤ 0.05). There were no significant differences in rates of all-cause mortality, infection or all-cause re-operation. CONCLUSIONS:: Compared to modern uncemented femoral stem designs, cemented stems yield lower rates of periprosthetic fracture requiring re-operation, without increasing risk of all-cause mortality. Tapered-wedge stems had similar rates of re-operation due to periprosthetic fracture as reamed uncemented stems.

Predicting sport and occupational lower extremity injury risk through movement quality screening: a systematic review.

BACKGROUND: Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. OBJECTIVE: To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. MATERIALS AND METHODS: 5 electronic databases were systematically searched. Studies selected included original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. 2 independent authors assessed the quality (Downs and Black (DB) criteria) and level of evidence (Oxford Centre of Evidence-Based Medicine model). RESULTS: Of 4361 potential studies, 17 were included. The majority were low-quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3-15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). 4 studies considered inter-relationships between risk factors, 7 reported diagnostic accuracy and none tested an intervention programme targeting individuals identified as high risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. CONCLUSIONS: Future research should focus on high-quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating preparticipation screening and LE injury prevention programmes through high-quality randomised controlled trials targeting individuals at greater risk of injury based on screening tests with validated test properties.

radR: an open-source platform for acquiring and analysing data on biological targets observed by surveillance radar.

BACKGROUND: Radar has been used for decades to study movement of insects, birds and bats. In spite of this, there are few readily available software tools for the acquisition, storage and processing of such data. Program radR was developed to solve this problem. RESULTS: Program radR is an open source software tool for the acquisition, storage and analysis of data from marine radars operating in surveillance mode. radR takes time series data with a two-dimensional spatial component as input from some source (typically a radar digitizing card) and extracts and retains information of biological relevance (i.e. moving targets). Low-level data processing is implemented in "C" code, but user-defined functions written in the "R" statistical programming language can be called at pre-defined steps in the calculations. Output data formats are designed to allow for future inclusion of additional data items without requiring change to C code. Two brands of radar digitizing card are currently supported as data sources. We also provide an overview of the basic considerations of setting up and running a biological radar study. CONCLUSIONS: Program radR provides a convenient, open source platform for the acquisition and analysis of radar data of biological targets.

Genetic mechanisms contributing to reduced tetracycline susceptibility of Campylobacter isolated from organic and conventional dairy farms in the midwestern and northeastern United States.

Campylobacter is one of the most common causes of gastroenteritis and can be acquired through contact with farm animals or the consumption of raw milk. Because of concerns over the role of food-producing animals in the dissemination of antimicrobial resistance to humans, we evaluated the prevalence of antimicrobial resistance in Campylobacter isolates from dairy farms and the genetic mechanism conferring the observed resistance. Evaluation of antimicrobial resistance was completed on 912 isolates from conventional and 304 isolates from organic dairy farms to eight drugs (azithromycin, chloramphenicol, ciprofloxacin, clindamycin, erythromycin, gentamicin, nalidixic acid, and tetracycline) with microbroth dilution. Resistance to seven of eight drugs was very low and did not differ by farm type. However, tetracycline resistance was common in Campylobacter isolated from both organic and conventional dairy farms, with 48 and 58% of isolates affected, respectively. By multiplex PCR, we determined that tetracycline resistance was highly associated with the carriage of tetO in Campylobacter isolates (X2 = 124, P < 0.01, kappa = 0.86).