A Novel Technique for Fixation of Non-union Unicondylar Hoffa’s Fracture: A Case Report

@#Hoffa fractures are rare and difficult fractures to manage. Hoffa fracture involves a coronal plane fracture of posterior femoral condyle. Non-union in Hoffa fracture is further difficult to manage. The surgical management for such nonunion includes open reduction with recon/LCP plate or screw fixation with bone grafting. The problem with plates is the difficulty in contouring the plates according to the shape of posterior femoral condyles. We describe a new technique with 2 L shaped neutralisation plates placed in a circular fashion. This technique provides a more rigid construct and gives better holding strength of screws in Hoffa fragment. This enhances union and mobilisation can be started early.

Development of a novel plaque reduction neutralisation test for hantavirus infection

In the Americas, hantaviruses cause severe cardiopulmonary syndrome (HCPS) with a high fatality rate. Hantavirus infection is commonly diagnosed using serologic techniques and reverse transcription-polymerase chain reaction. This paper presents a novel plaque reduction neutralisation test (PRNT) for detecting antibodies to Brazilian hantavirus. Using PRNT, plaque detection was enhanced by adding 0.6% of dimethyl sulfoxide into the overlay culture medium of the infected cells. This procedure facilitated clear visualisation of small plaques under the microscope and provided for easy and accurate plaque counting. The sera from 37 HCPS patients from the city of Ribeirão Preto, Brazil was evaluated for the Rio Mamoré virus (RIOMV) using PRNT. Six samples exhibited neutralising antibodies; these antibodies exhibited a low titre. The low level of seropositive samples may be due to fewer cross-reactions between two different hantavirus species; the patients were likely infected by Araraquara virus (a virus that has not been isolated) and RIOMV was used for the test. This assay offers a new approach to evaluating and measuring neutralising antibodies produced during hantavirus infections and it can be adapted to other hantaviruses, including viruses that will be isolated in the future.

Neutralising antibodies for West Nile virus in horses from Brazilian Pantanal

Despite evidence of West Nile virus (WNV) activity in Colombia, Venezuela and Argentina, this virus has not been reported in most South American countries. In February 2009, we commenced an investigation for WNV in mosquitoes, horses and caimans from the Pantanal, Central-West Brazil. The sera of 168 horses and 30 caimans were initially tested using a flaviviruses-specific epitope-blocking enzyme-linked immunosorbent assay (blocking ELISA) for the detection of flavivirus-reactive antibodies. The seropositive samples were further tested using a plaque-reduction neutralisation test (PRNT90) for WNV and its most closely-related flaviviruses that circulate in Brazil to confirm the detection of specific virus-neutralising antibodies. Of the 93 (55.4 percent) blocking ELISA-seropositive horse serum samples, five (3 percent) were seropositive for WNV, nine (5.4 percent) were seropositive for St. Louis encephalitis virus, 18 (10.7 percent) were seropositive for Ilheus virus, three (1.8 percent) were seropositive for Cacipacore virus and none were seropositive for Rocio virus using PRNT90, with a criteria of > four-fold antibody titre difference. All caimans were negative for flaviviruses-specific antibodies using the blocking ELISA. No virus genome was detected from caiman blood or mosquito samples. The present study is the first report of confirmed serological evidence of WNV activity in Brazil.

Anticuerpos neutralizantes contra el virus de la fiebre amarilla 17 D en colombianos vacunados y no vacunados con inmunidad a dengue / Yellow fever virus 17D neutralising antibodies in vaccinated Colombian people and unvaccinated ones having immunity against dengue

Objetivo Determinar la frecuencia de título protector de anticuerpos neutralizantes contra el virus de la fiebre amarilla (AN-VFA a título >1:10) en colombianos vacunados con la cepa 17 D y conocer la magnitud de neutralización del VFA por anticuerpos contra dengue. Metodología Se colectó suero de 100 individuos con vacuna documentada por carné y de 116 residentes en municipios de Norte de Santander afectados por el brote en 2002-2003, quienes informaron haber sido vacunados. Se incluyeron sueros de individuos no vacunados con (n=61) y sin (n=16) anticuerpos contra dengue. Todos los sueros se analizaron por la prueba de neutralización para VFA por 75 por ciento de reducción de placa. Resultados AN-VFA a título >1:10 se encontraron en 90 por ciento de vacunados con carné y sin variación aparente en relación con edad. Al contrario, hubo correlación entre disminución de la frecuencia de título protector de anticuerpos e incremento del tiempo de inmunización (r=0,95; p=0,04). En residentes de Norte de Santander, AN-VFA a título >1:10 se encontraron en 92,6 por ciento adultos y 69 por ciento niños. El VFA fue neutralizado (52 -100 por ciento) por sueros de inmunes a dengue más eficientemente que por sueros de no inmunes (p<0.001). Conclusiones Vacunados con el virus 17 D podrían no estar protegidos contra fiebre amarilla: hasta 31 por ciento niños y 10 por ciento adultos. Anticuerpos contra dengue inhibieron el VFA y su significancia en términos de protección contra fiebre amarilla deberá ser investigada.

Objective Determining the frequency of yellow fever seroprotective antibody neutralising titres (YF-NT >1:10) in Colombians vaccinated with the 17 D virus and ascertaining the extent to which YF virus can be neutralised by dengue antibodies. Materials and Methods Serum samples were taken from 100 subjects who showed their vaccination record and from 116 residents in municipalities (Norte de Santander) affected by a wild YF outbreak in 2002-2003 who were reported to have been YF vaccinated. Sera from individuals with (n=61) and without (n=16) dengue antibodies who had never been YF vaccinated were included. All the sera were tested by 75 percent YF plaque-reduction neutralization test. Results YF-NT titres >1:10 were founded in 90 percent of subjects with vaccination recorded with minors variations in relation to age. In contrast, there was correlation between decrease of seroprotective YF-NT titres frequency and increase of immunization time (r=0.95; p=0.04). In residents in YF endemic area, YF-NT titres > 1.10 were founded in 92,6 percent adults and 69 percent children. YF 17 D virus was neutralized (52-100 percent) by dengue sera more efficiently than non-dengue immune sera (p<0.001). Conclusions Individuals immunised with YF vaccine 17 D could not be protected against YF: up to 31 percent children and 10 percent adults. Dengue antibodies inhibited YF virus and its significance in terms of YF protection must be investigated.