Hinged versus CCK revision arthroplasty for the stiff total knee.

BACKGROUND: Total knee arthroplasty (TKA) remains the gold standard for end-stage knee osteoarthritis. The prevalence of stiffness after this procedure described in literature varies from 1.3% to 5.3%. The causes of arthrofibrosis after total knee arthroplasty are multifactorial. Revision TKA is a successful procedure when performed for loosening, instability, mechanical implant failure, or infection. The results of revision TKA for idiopathic arthrofibrosis and stiffening are however less favorable. PURPOSE: It has been the authors' impression that the poor results in arthrofibrosis could be in part related to the use of traditional PS or CCK-type revision implants. Our hypothesis is that better results can be achieved in case a rotating hinge design (RHK) is used. The reason could be that RHK designs allow for much more aggressive capsuloligament debridement and therefore more adequate fibrosis removal, while securing optimal implant stability, tibiofemoral rotational freedom, and flexion-extension space stability. The purpose of our study was to investigate in our database whether this hypothesis is correct. METHODS: Retrospectively, 40 patients with the defined range of knee motion were identified. Patients with underlying mechanical malalignment, component malposition, soft-tissue imbalance or infections were excluded. Twenty-two patients received a hinged-type prosthetic device (18 Zimmer RHK, four Stryker RHK) and 18 patients received a less constrained condylar type prosthetic device (17 Legion CCK, one Vanguard CCK). RESULTS: Preoperative data were similar for RHK as CCK-type implants except for knee pain score, which was significantly worse for the RHK group (36 vs 44, p = 0.049). At two years of follow-up, compared to CCK, the RHK group demonstrated significantly better postoperative results for knee function scores (68.9 vs 54.2, p = 0.0015), knee function improvement (22.8 vs 4.8, p = 0.0015), knee pain improvement (26.4 vs 9.4, p = 0.0050), greater maximal flexion (99.9° vs 81.4°, p = 0.0005), better maximal extension (-1.9° vs -6.2°, p = 0.0447), greater flexion gain (35.8° vs 14.2°, p = 0.0002), and greater extension gain (8.6° vs 2.0°, p = 0.0083). CONCLUSION: Our data show that revision arthroplasty of the stiff knee using a rotating hinged device can provide excellent results in selected cases. To date, this is the first study to describe the difference in outcome between revision total knee arthroplasty for idiopathic arthrofibrosis using a hinged or a constrained condylar knee device.

Developing and validating the Cutaneous WARTS (CWARTS) diagnostic tool: a novel clinical assessment and classification system for cutaneous warts.

BACKGROUND: The clinical appearance of cutaneous warts is highly variable and not standardized. OBJECTIVES: To develop and validate a reproducible clinical tool for the standardized assessment of cutaneous warts to distinguish these lesions accurately. METHODS: Nine morphological characteristics were defined and validated regarding intra- and interobserver agreement. Based on literature and semistructured interviews, a systematic dichotomous assessment tool, the Cutaneous WARTS (CWARTS) diagnostic tool was developed. The validation consisted of two independent parts performed with photographs from the recent WARTS-2 trial. In part A, the CWARTS diagnostic tool was tested by 28 experienced physicians who assessed photographs of 10 different warts to investigate interobserver concordance. In part B, morphological characteristics were validated by masked and independent scoring of 299 photographs by six different observers. Part B also entailed reassessment of the photographs after at least 1 week. The primary outcome measurement was the intraclass correlation coefficient (ICC). RESULTS: Presence of black dots (capillary thrombosis) had the greatest ICC (0·85) for interobserver agreement in part A, followed by arrangement (0·65), presence of border erythema (0·64) and sharpness of the border (0·60). In part B, results were similar for interobserver agreement with presence of black dots having the highest ICC (0·68), followed by border erythema (0·64), arrangement (0·58) and colour (0·55). For intraobserver agreement, presence of black dots had the highest agreement (0·70), followed by presence of border erythema (0·694) and colour (0·59). CONCLUSIONS: Wart phenotype can be reliably assessed using the CWARTS diagnostic tool.

Morphological characteristics and human papillomavirus genotype predict the treatment response in cutaneous warts.

BACKGROUND: Cutaneous warts have a cure rate after therapy of no more than approximately 50%. Recently, we developed and validated a standard assessment tool for warts (Cutaneous WARTS diagnostic tool, CWARTS) based on phenotypical characteristics. OBJECTIVES: To assess whether patient and morphological wart characteristics predict the human papillomavirus (HPV) type in a specific wart and whether these characteristics as well as the HPV type predict a favourable treatment response. METHODS: Photographs were used to score nine morphological wart characteristics using the newly developed CWARTS tool. Genotyping of 23 wart-associated HPV types was performed using the hyperkeratotic skin lesion-polymerase chain reaction/multiplex genotyping assay. The results were correlated with a favourable response to treatment with monochloroacetic acid, cryotherapy or a combination of cryotherapy and salicylic acid. Odds ratios were calculated using logistic regression in a generalized estimating equations model. RESULTS: Black dots (capillary thrombosis) strongly predicted the presence of any HPV type in a wart. From all characteristics tested, the HPV type most strongly predicted the treatment response when the warts were treated with monochloroacetic acid or a combination of cryotherapy and salicylic acid with a significantly decreased treatment response if the warts contained HPVs of the alpha genus (HPV2, HPV27 or HPV57). When cryotherapy alone was used for common warts, HPV type did not play a role, but cryotherapy was less effective in the presence of callus and when the wart was located deeper in the skin. CONCLUSIONS: Morphological characteristics of the warts and the HPV genotype influence treatment outcome and thus potentially influence future treatment decisions for common and plantar warts.

A quantitative swab is a good non-invasive alternative to a quantitative biopsy for quantifying bacterial load in wounds healing by second intention in horses.

The aim of this study was to evaluate different techniques for diagnosing wound infection in wounds healing by second intention in horses and to assess the effect of a vortex and sonication protocol on quantitative bacteriology in specimens with a histologically confirmed biofilm. In 50 wounds healing by second intention, a clinical assessment, a quantitative swab, a semi-quantitative swab, and a swab for cytology were compared to a quantitative tissue biopsy (reference standard). Part of the biopsy specimen was examined histologically for evidence of a biofilm. There was a significant, high correlation (P<0.001; r=0.747) between the outcome of the quantitative swabs and the quantitative biopsies. The semi-quantitative swabs showed a significant, moderate correlation with the quantitative biopsies (P<0.001; ρ=0.524). Higher white blood cell counts for cytology were significantly associated with lower log10 colony-forming units (CFU) in the wounds (P=0.02). Wounds with black granulation tissue showed significantly higher log10 CFU (P=0.003). Specimens with biofilms did not yield higher bacteriological counts after a vortex and sonication protocol was performed to release bacteria from the biofilm. Based on these findings, a quantitative swab is an acceptable non-invasive alternative to a quantitative biopsy for quantifying bacterial load in equine wounds healing by second intention.

Novel approaches to assess the quality of fertility data stored in dairy herd management software.

Scientific journals and popular press magazines are littered with articles in which the authors use data from dairy herd management software. Almost none of such papers include data cleaning and data quality assessment in their study design despite this being a very critical step during data mining. This paper presents 2 novel data cleaning methods that permit identification of animals with good and bad data quality. The first method is a deterministic or rule-based data cleaning method. Reproduction and mutation or life-changing events such as birth and death were converted to a symbolic (alphabetical letter) representation and split into triplets (3-letter code). The triplets were manually labeled as physiologically correct, suspicious, or impossible. The deterministic data cleaning method was applied to assess the quality of data stored in dairy herd management from 26 farms enrolled in the herd health management program from the Faculty of Veterinary Medicine Ghent University, Belgium. In total, 150,443 triplets were created, 65.4% were labeled as correct, 17.4% as suspicious, and 17.2% as impossible. The second method, a probabilistic method, uses a machine learning algorithm (random forests) to predict the correctness of fertility and mutation events in an early stage of data cleaning. The prediction accuracy of the random forests algorithm was compared with a classical linear statistical method (penalized logistic regression), outperforming the latter substantially, with a superior receiver operating characteristic curve and a higher accuracy (89 vs. 72%). From those results, we conclude that the triplet method can be used to assess the quality of reproduction data stored in dairy herd management software and that a machine learning technique such as random forests is capable of predicting the correctness of fertility data.

Short communication: Limitations of glucose tolerance tests in the assessment of peripheral tissue insulin sensitivity during pregnancy and lactation in dairy heifers.

The aim of the present study was to point at the limitations of glucose tolerance tests (GTT) to assess peripheral tissue insulin sensitivity in dairy heifers in different physiological states (pregnancy and lactation). Intravenous GTT were performed in 5 nonpregnant, nonlactating heifers, 5 heifers at the end of pregnancy (12-7 d before calving), and 5 lactating primiparous cows (11-14 d after calving). Glucose and insulin concentrations were determined and area under the curve (AUC) and clearance rate of glucose and insulin were calculated. Additionally, data were analyzed using the minimal model to derive the insulin sensitivity parameter (Si). Basal glucose and insulin concentrations were greater in the nonpregnant, nonlactating heifers. Clearance rate of glucose and Si were lowest, whereas the AUC for glucose was greatest in the nonpregnant, nonlactating heifers. Insulin concentrations during the GTT were greater for the nonpregnant, nonlactating heifers. Results from the GTT in pregnant heifers and lactating primiparous cows are biased by the fact that a large part of the glucose disappearance during an intravenous GTT occurs independently of insulin by the pregnant uterus or the lactating mammary gland. As such, greater AUC of glucose, lower clearance rate of glucose, or lower Si derived from GTT performed in nonpregnant, nonlactating dairy heifers in the present study might indicate decreased peripheral tissue insulin sensitivity of the glucose metabolism or decreased insulin-independent glucose disappearance. Based on the results from a GTT, it is impossible to discriminate between both metabolic pathways. It can be concluded that parameters derived from GTT are not suited to compare peripheral tissue insulin sensitivity of the glucose metabolism between dairy heifers in different physiological states due to the large variation in insulin secretion and the substantial difference in insulin-independent glucose disposal associated with these physiological states.

Validation of different measures of insulin sensitivity of glucose metabolism in dairy cows using the hyperinsulinemic euglycemic clamp test as the gold standard.

The aim of the present research was to compare different measures of insulin sensitivity in dairy cows at the end of the dry period. To do so, 10 clinically healthy dairy cows with a varying body condition score were selected. By performing hyperinsulinemic euglycemic clamp (HEC) tests, we previously demonstrated a negative association between the insulin sensitivity and insulin responsiveness of glucose metabolism and the body condition score of these animals. In the same animals, other measures of insulin sensitivity were determined and the correlation with the HEC test, which is considered as the gold standard, was calculated. Measures derived from the intravenous glucose tolerance test (IVGTT) are based on the disappearance of glucose after an intravenous glucose bolus. Glucose concentrations during the IVGTT were used to calculate the area under the curve of glucose and the clearance rate of glucose. In addition, glucose and insulin data from the IVGTT were fitted in the minimal model to derive the insulin sensitivity parameter, Si. Based on blood samples taken before the start of the IVGTT, basal concentrations of glucose, insulin, NEFA, and ß-hydroxybutyrate were determined and used to calculate surrogate indices for insulin sensitivity, such as the homeostasis model of insulin resistance, the quantitative insulin sensitivity check index, the revised quantitative insulin sensitivity check index and the revised quantitative insulin sensitivity check index including ß-hydroxybutyrate. Correlation analysis revealed no association between the results obtained by the HEC test and any of the surrogate indices for insulin sensitivity. For the measures derived from the IVGTT, the area under the curve for the first 60 min of the test and the Si derived from the minimal model demonstrated good correlation with the gold standard.

Influence of adipocyte size and adipose depot on the in vitro lipolytic activity and insulin sensitivity of adipose tissue in dairy cows at the end of the dry period.

The aim of the present research was to describe characteristics of adipose tissue lipolysis in dairy cows with a variable body condition score (BCS). Ten clinically healthy Holstein Friesian cows were selected based on BCS and euthanized 10 to 13 d before the expected parturition date. Immediately after euthanasia, adipose tissue samples were collected from subcutaneous and omental fat depots. In both depots, we observed an increase in adipocyte size with increasing BCS. Using an in vitro explant culture of subcutaneous and omental adipose tissue, we aimed to determine the influence of adipocyte size and localization of adipose depot on the lipolytic activity in basal conditions and after addition of isoproterenol (nonselective ß-agonist) and insulin in different concentrations. Glycerol release in the medium was used as a measure for lipolytic activity. We observed that the basal lipolytic activity of subcutaneous and omental adipose tissue increased with adipocyte volume, meaning that larger fat cells have higher basal lipolytic activity independent of the location of the adipose depot. Dose-response curves were created between the concentration of isoproterenol or insulin and the amount of glycerol released. The shape of the dose-response curves is determined by the concentration of isoproterenol and insulin needed to elicit the half-maximal effect and the maximal amount of stimulated glycerol release or the maximal inhibitory effect of insulin. We observed that larger fat cells released more glycerol upon maximal stimulation with isoproterenol and this was more pronounced in subcutaneous adipose tissue. Additionally, larger fat cells had a higher sensitivity toward lipolytic signals. We observed a trend for larger adipocytes to be more resistant to the maximal antilipolytic effect of insulin. The insulin concentration needed to elicit the half-maximal inhibitory effect of insulin was within the physiological range of insulin and was not influenced by adipocyte size or adipose depot. We conclude that overconditioned cows have larger adipocytes and are predisposed to excessive mobilization of body fat due to a higher basal and stimulated lipolytic activity of large adipocytes while the antilipolytic effect of insulin is preserved.

Insulin response of the glucose and fatty acid metabolism in dry dairy cows across a range of body condition scores.

The objective of the present research was to determine the insulin response of the glucose and fatty acid metabolism in dry dairy cows with a variable body condition score (BCS). Ten pregnant Holstein Friesian dairy cows (upcoming parity 2 to 5) were selected based on BCS at the beginning of the study (2mo before expected parturition date). During the study, animals were monitored weekly for BCS and backfat thickness and in the last 2wk, blood samples were taken for determination of serum nonesterified fatty acid (NEFA) concentration. Animals underwent a hyperinsulinemic euglycemic clamp test in the third week before the expected parturition date. The hyperinsulinemic euglycemic clamp test consisted of 4 consecutive insulin infusions with increasing insulin doses: 0.1, 0.5, 2, and 5mIU/kg per minute. For each insulin infusion period, a steady state was defined as a period of 30min where no or minor changes of the glucose infusion were necessary to keep the blood glucose concentration constant and near basal levels. During the steady state, the glucose infusion rate [steady state glucose infusion rate (SSGIR) in µmol/kg per minute] and NEFA concentration [steady state NEFA concentration (SSNEFA) in mmol/L] were determined and reflect the insulin response of the glucose and fatty acid metabolism. Dose response curves were created based on the insulin concentrations during the steady state and the SSGIR or SSNEFA. The shape of the dose response curves is determined by the concentration of insulin needed to elicit the half maximal effect (EC50) and the maximal SSGIR or the minimal SSNEFA for the glucose or fatty acid metabolism, respectively. The maximal SSGIR was negatively associated with variables reflecting adiposity of the cows (BCS, backfat thickness, NEFA concentration during the dry period, and absolute weight of the different adipose depots determined after euthanasia and dissection of the different depots), whereas the EC50 of the glucose metabolism was positively associated with these variables. These results reflect a decreased insulin sensitivity and a decreased insulin responsiveness of the glucose metabolism in overconditioned dry dairy cows. The minimal SSNEFA and the EC50 of the fatty acid metabolism were not associated with variables reflecting adiposity of the cows, meaning that the insulin response of the fatty acid metabolism was not associated with the level of fat accumulation in dry dairy cows. Additionally, within individual cows, the EC50 of the glucose metabolism was higher than the EC50 of the fatty acid metabolism, meaning that the response of the fatty acid metabolism occurs at lower insulin concentrations compared with the response of the glucose metabolism. It can be concluded that a negative association exists between the level of fat accumulation in pregnant dairy cows at the end of the dry period and the insulin response of the glucose metabolism.

Effects of semi-group housing and floor type on pododermatitis, spinal deformation and bone quality in rabbit does.

The most common housing system for reproduction rabbits, individual cage housing on a wire floor, is increasingly scrutinized because of its potential detrimental impact on animal welfare. We compared three types of housing: (1) individual cage housing on a wire floor (3952 cm2/doe, maximum roof height 63 cm, one 1000 cm2 plastic footrest/doe), (2) semi-group housing on a wire floor (5000 cm2/doe, roofless, one 1000 cm2 plastic footrest/doe) and (3) the same semi-group housing, but with a fully plastic slatted floor. In all housing systems, does had free access to an elevated platform. In the semi-group housing pens, four does were housed communally during 21 days of the reproduction cycle (to allow more space for locomotion and to increase opportunities for social contact), and individually during the other 21 days of the cycle (to minimize doe-doe and doe-kit aggression that peaks around kindling). In all, 24 Hycole does were included per system. The does entered the experiment at 203 days of age (after their first parity). The experiment consisted of four reproductive cycles, ending at 369 days of age. Pododermatitis was scored in cycles 1, 2 and 4. At the end of the 4th cycle the does were euthanized and X-rays were taken to assess spinal deformation. Tibia and femur length, width and cortical thickness were determined and bone strength was assessed using a shear test, as a measure of bone quality. Although severe pododermatitis was absent, the prevalence of plantar hyperkeratosis (hair loss and callus formation) at the end of the 4th cycle was much greater on the wire floor (65% and 68% for semi-group housing and individual cages, respectively) than on the plastic floor (5%, P<0.0001), even though the wire floors were equipped with a plastic footrest known to decrease hyperkeratosis. In contrast to our expectations, semi-group housing did not affect the prevalence of spinal deformations (P>0.10), but in line with our expectations bone quality was affected favourably by semi-group housing. The tibial cortex (and to a lesser extent the femoral cortex) was thicker in semi-group housing than in individual cages (1.45, 1.46 and 1.38 mm for semi-group housing on wire, semi-group housing on plastic and individual housing on wire, respectively, P=0.045). What this increase in cortical thickness means in terms of doe welfare requires further study, as it may reflect an increase in activity resulting either from increased space for locomotion, or from fleeing aggressive pen mates.

Functional connectivity in preterm infants derived from EEG coherence analysis.

OBJECTIVE: To quantify the neuronal connectivity in preterm infants between homologous channels of both hemispheres. METHODS: EEG coherence analysis was performed on serial EEG recordings collected from preterm infants with normal neurological follow-up. The coherence spectrum was divided in frequency bands: δnewborn(0-2 Hz), θnewborn(2-6 Hz), αnewborn(6-13 Hz), ßnewborn(13-30 Hz). Coherence values were evaluated as a function of gestational age (GA) and postnatal maturation. RESULTS: All spectra show two clear peaks in the δnewborn and θnewborn-band, corresponding to the delta and theta EEG waves observed in preterm infants. In the δnewborn-band the peak magnitude coherence decreases with GA and postnatal maturation for all channels. In the θnewborn-band, the peak magnitude coherence decreases with GA for all channels, but increases with postnatal maturation for the frontal polar channels. In the ßnewborn-band a modest magnitude coherence peak was observed in the occipital channels, which decreases with GA. CONCLUSIONS: Interhemispherical connectivity develops analogously with electrocortical maturation: signal intensities at low frequencies decrease with GA and postnatal maturation, but increase at high frequencies with postnatal maturation. In addition, peak magnitude coherence is a clear trend indicator for brain maturation. SIGNIFICANCE: Coherence analysis can aid in the clinical assessment of the functional connectivity of the infant brain with maturation.

A GFP promoter fusion library for the study of Salmonella biofilm formation and the mode of action of biofilm inhibitors.

Salmonella, an important foodborne pathogen, forms biofilms in many different environments. The composition of these biofilms differs depending on the growth conditions, and their development is highly coordinated in time. To develop efficient treatments, it is therefore essential that biofilm formation and its inhibition be understood in different environments and in a time-dependent manner. Many currently used techniques, such as transcriptomics or proteomics, are still expensive and thus limited in their application. Therefore, a GFP-promoter fusion library with 79 important Salmonella biofilm genes was developed (covering among other things matrix production, fimbriae and flagella synthesis, and c-di-GMP regulation). This library is a fast, inexpensive, and easy-to-use tool, and can therefore be conducted in different experimental setups in a time-dependent manner. In this paper, four possible applications are highlighted to illustrate and validate the use of this reporter fusion library.

Cytotoxicity and anti-inflammatory activity of cyclosporine A loaded PLGA nanoparticles for ocular use.

Cyclosporine A loaded poly(lactide-co-glycolide) nanoparticles were prepared using the o/w emulsification solvent evaporation method and the effect of four preparation parameters on particle size and zeta potential was investigated. Release properties of the nanoparticles were examined and in vitro experiments were performed in order to evaluate the cytotoxicity and anti-inflammatory activity of the nanoparticles developed. Particle sizes varied between 191 and 303 nm depending on the different preparation parameters and all nanoparticle dispersions were monodisperse. The nanoparticles showed negative zeta potential values varying between -16 and -35 mV and 57 to 70 % of the amount of loaded cyclosporine A was released after 24 h. None of the nanoparticle formulations showed significant cytotoxicity compared to the negative control using human epithelial cells (HaCaT). Cyclosporine A incorporated in the various nanoparticle formulations retained its anti-inflammatory activity as significant suppression of interleukine-2 secretion in concanavalin A stimulated Jurkat T cells was measured. As the overall influence of the freeze-drying process on the characteristics of nanoparticles was limited, trehalose and carnitine should be preferred as cryoprotectants in ocular formulations for treatment of dry eye disease.

The nasal vestibulum is the optimal sampling site for MRSA screening in hospitalised horses.

The increased incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in equine hospitals highlights the need for infection control protocols based on optimal patient screening. In horses, the deep ventral meatus of the nasal cavity is the principal site sampled to detect MRSA. However, in humans, the anterior nares are the preferred sampling site. The objective of this study was to determine the optimal sampling location in the nasal chambers for MRSA in horses by comparing the results obtained from three different locations (the vestibulum, diverticulum and ventral meatus) in 240 hospitalised animals. Antimicrobial susceptibility testing and epidemiological typing were conducted on representative subsets of the isolates obtained. Compared to the more invasive ventral meatus sampling (relative sensitivity 68.9%; isolation rate 37.9%), vestibulum (RS 81.1%; IR 44.6%, P=0.13) and diverticulum (RS 52.3%; IR 28.8%, P=0.03) sampling were more or less sensitive, respectively. In total, 132 horses (55%) were MRSA positive with the vast majority (98.5%) carrying genotyped isolates of the livestock-associated (LA)-MRSA clonal complex (CC) 398, and only a minority (1.5%) CC8. Of the 22 MLST typed isolates, five belonged to a novel ST2197 (t011, CC398). Although 93.9% of the isolates were multi-resistant (to ß-lactam, tetracycline, trimethoprim, and gentamicin), <5% were resistant to virtually all antimicrobials commonly used in equine medicine. The study findings indicate that detection of MRSA in horses may be enhanced by replacing the traditional deep sampling of the ventral nasal meatus by the less invasive approach of sampling the nasal vestibulum.

MRSA carriage in the equine community: an investigation of horse-caretaker couples.

Equine methicillin-resistant Staphylococcus aureus (MRSA) carriage entails a risk of both equine and zoonotic transmission and infection. In Europe, CC398, the livestock-associated (LA-)MRSA is highly prevalent in horses and veterinary personnel at equine clinics. The extent of the MRSA reservoir created by healthy horses from the general population and associated health hazard for their daily caretakers is, however, unknown. This study aimed at screening healthy horse-caretaker couples from a broad range of home farms. At five equine gatherings, 166 couples were selected for MRSA screening in the anterior nares and participation in an epidemiologic survey. All MRSA isolates were subjected to genotyping and antimicrobial susceptibility testing. Only 4 humans (2.4%) and 2 of their horses (1.2%) tested MRSA positive. Within the 2 couples where both partners were positive, man and horse carried isolates belonging to identical, livestock-associated spa types (t011 and t2330) and demonstrating equal antimicrobial susceptibility patterns. For all LA-MRSA positive humans (n=3) and animals (n=2) regular (in)direct contact with the veterinary sector was reported. A significant association between the horses' carriage status and transportation to an event could not be demonstrated (P=1.00). In conclusion, outside equine clinics, the extent of the MRSA reservoir in horses and their caretakers was low. Travel to an equine gathering could not be withheld as a risk factor for equine MRSA carriage, whereas indications were found that contact with veterinary care may predispose both healthy horses and their handlers to carriage.

The newly described mecA homologue, mecALGA251, is present in methicillin-resistant Staphylococcus aureus isolates from a diverse range of host species.

OBJECTIVES: A previously unidentified mecA homologue, mecA(LGA251), has recently been described in methicillin-resistant Staphylococcus aureus (MRSA) from humans and dairy cattle. The origin and epidemiology of this novel homologue are unclear. The objective of this study was to provide basic descriptive information of MRSA isolates harbouring mecA(LGA251) from a range of host animal species. METHODS: A number of S. aureus isolates from historical animal isolate collections were chosen for investigation based on their similarity to known mecA(LGA251) MRSA isolates. The presence of mecA(LGA251) was determined using a multiplex PCR and antimicrobial susceptibility testing performed by disc diffusion. RESULTS: MRSA harbouring mecA(LGA251) were found in isolates from a domestic dog, brown rats, a rabbit, a common seal, sheep and a chaffinch. All of the isolates were phenotypically MRSA, although this depended on which test was used; some isolates would be considered susceptible with certain assays. All isolates were susceptible to linezolid, rifampicin, kanamycin, norfloxacin, erythromycin, clindamycin, fusidic acid, tetracycline, trimethoprim/sulfamethoxazole and mupirocin. Five multilocus sequence types were represented (2273, 130, 425, 1764 and 1245) and six spa types (t208, t6293, t742, t6594, t7914 and t843). CONCLUSIONS: The discovery of MRSA isolates possessing mecA(LGA251) from a diverse range of host species, including different taxonomic classes, has important implications for the diagnosis of MRSA in these species and our understanding of the epidemiology of this novel mecA homologue.

Methicillin-resistant Staphylococcus aureus (MRSA) on the skin of long-term hospitalised horses.

Given the significance of methicillin-resistant Staphylococcus aureus (MRSA) infections for both horses and staff in equine veterinary hospitals, protocols are required to minimise the risk of nosocomial transmission, including the screening of the skin and nasal chambers of equine patients for evidence of infection. The objective of this study was to clarify the potential existence and extent of MRSA on the skin of horses requiring long-term hospitalisation (≥ 6 months). Thirty such horses were sampled at eight different locations on their skin and from their nasal chambers. MRSA was isolated from 12 animals (40%), with all sample sites testing positive on at least one occasion. Organisms were most frequently detected in the nasal chambers (relative sensitivity, 83.3%; 34.5% positive horses; isolation rate 33.3%). Skin presence was found in 30% of animals with the highest isolation rates found at the carpus (16.7%), neck, withers and croup (13.3% each). To achieve a relative screening sensitivity of >90%, at least one skin site was required in addition to nasal sampling. This evidence of skin as well as nasal reservoirs of MRSA in long-term hospitalised horses should facilitate the design of effective screening and containment protocols.

Comparison of radiography and CT to identify changes in the skulls of four rabbits with dental disease.

Four domestic pet rabbits with dental pathology were presented at a university clinic. In addition to conducting physical examinations of the rabbits, radiographic and computed tomographic (CT) images of the rabbits' heads were obtained. Three rabbits were euthanized at the owners' request, and anatomic sections of the skulls were made. The observations of the anatomic sections, radiographs, and CT images are described. The abnormalities found on the radiographs and CT images were very similar to the findings on the anatomic sections. Compared to radiography, the CT images provided more details about the extent of the dental pathology, which is likely to be important for establishing a more precise prognosis and a more informed decision making process.