Comparison of ultrasound-guided vs. 'blind' techniques for intra-synovial injections of the shoulder area in horses: scapulohumeral joint, bicipital and infraspinatus bursae.

REASONS FOR PERFORMING STUDY: Diagnosis and treatment of pathologies involving synovial structures in the shoulder region are technically difficult. Ultrasound-guided (UG) injection techniques have been shown to be highly accurate, safe and reliable for various structures in human and equine patients. OBJECTIVES: To develop easy-to-use and reliable UG injection techniques for the infraspinatus bursa (IB), bicipital bursa (BB) and scapulohumeral joint (SHJ) and to compare them with conventional 'blind' methods. METHODS: Eight pairs of equine shoulders were positioned on a computed-tomography (CT) table with left and right shoulders randomly assigned to Operator A (UG) and Operator B ('blind'). Contrast medium mixed with methylene blue was injected into the target structures. Time and number of attempts for correct needle placement and ease of injection were recorded. A CT scan of each shoulder was performed after every injection to evaluate the location of contrast material. Once injections and CT scans were completed, anatomic dissections were conducted. Statistical analysis was used to compare UG and 'blind' techniques with significance set at P<0.05. RESULTS: Intra-synovial injections using UG techniques were successful in all 24 synovial structures compared with 14/24 with conventional methods. The median number and range of needle repositioning to obtain accurate needle placement was 1 (1-2) for UG and 2 (1-4) for the 'blind' techniques. The median time and range required for accurate needle placement was 75.5 s (32-210 s) for UG and 43.5 s (11-140) for 'blind' technique. In 31% of all attempts, ease of injection was not indicative of successful intra-synovial administration. CONCLUSIONS: Ultrasound-guided injections of IB, BB and SHJ proved to be highly reliable and more accurate than conventional 'blind' techniques. POTENTIAL RELEVANCE: Ultrasound-guided injection techniques may be of great help for equine practitioners in the diagnosis and treatment of pathologies involving synovial structures in the shoulder region. Further work is needed to confirm these results in clinical cases.

The germ-spectrum problem and antibiotic-resistance in Bida and Minna hospitals--Nigeria.

In the present paper the occurrence of different species of Pseudomonas, of Acinetobacter calcoaceticum var. anitratum and Aeromonas hydrophila in hospitals is described. The possible human pathogenic significance is discussed.

A contribution to the situation of antibiotic resistance in Abeokuta (Ogunstate) and Minna (Nigerstate) in Nigeria.

After testing various chemotherapeutics the following conclusions could be drawn: Pseudomonas was sensitive only to gentamicin. Gentamicin, aminopenicilline + calvulanacid and cefoxitin were 100% effective against E. coli. Gentamicin also proved effective against Enterobacter (83%). Cefoxitin, aminopenicillin + clavulanacid, gentamicin and trimethoprim + sulfonamide were effective against Klebsiella. Concerning Proteus sp., cefoxitin showed best results (100%). Acinetobacter was 100% inhibited by gentamicin. Gentamicin was most effective (93% sensitivity) against Staph. aureus. Trimethoprim + sulfonamide and erythromycine showed resistance rate of 17%, cefalosporine and isoxazolylpenicilline a rate of 21%. Aminopenicillin and aminopenicilline + calvulanacid were most suitable against Enterococcus (100%).

Leptospirosis in the Melut district--upper Nile province (south Sudan)--an overview.

The authors examined 195 domestic animals for leptospirosis serologically in Sudan (170 cattle, 7 sheep and 18 goats) and 771 wild animals (36 species) with 13 serovars from 13 serogroups. 54% of domestic animals namely, 108 cattle and 1 sheep were positive in titer levels of 1:400 and higher. Cattle sera with the serovars of the serogroup Icterohaemorrhagiae were 2.4% positive with Cynopteri 2.4%, Autumnalis 3.5%, Australis 1.2%, Pomona 2.9%, Grippotyphosa 2.9%, Hebdonadis 17.1%, Bataviae 9.4% and Tarassovi 50.6%. Only one Numida meleagris of the 54 wild birds (14 species) was positive in low titer level of 1:100 with L. canicola. Seventy (9.8%) of the 717 wild mammals (22 species) examined were positive namely with the serovars of the serogroups Icterohaemorrhagiae 3.4%, Javanica 3.0%, Pomona 2.0%, Grippotyphosa 0.7%, Hebdomadis 0.4%, Ballum, Australis, Pyrogenes, Bataviae each 0.3% and Cynopteri 0.1%, whereby sera from 7 animals reacted simultaneously with the serovars of two serogroups. With regard to the species, positive reactions were found in Erinaceus albiventris, Eidolon helbum, Cercopithecus aethiops, Genetta spec., Canis adustus et aurus, Felis silvestris, Leptailurus serval, Arvicanthis niloticus, Mastomys spec., Mus spec., Gazella spec., Tragelaphus spec. The positivity in rodents was very low - 1.2%.

[Serological studies of cytomegalovirus in the Melut district, South Sudan]. / Serologische untersuchungen auf Cytomegalie im Distrikt Melut, Südsudan.

Out of 1071 investigated patients had antibodies in 73.7% against Cytomegalovirus. 99 ambulant Kala-Azar-patients reacted positive in 33%. Inhabitants of different villages have shown 35.2 to 50% positive reactions. Patients with hepato-splenomegaly in 94% and patients with diarrhoea and fever in 81% were positive.

Results of serological examination for leptospirosis of domestic and wild animals in the Upper Nile province (Sudan).

195 domestic and 766 wild animals were serologically examined for leptospirosis. Cattle was found to be positive at titres 1 greater than or equal to 400 in 63.5%, namely 50.6% for Tarassovi, 17.1% for Sejroe-Hebdomadis, 9.4% for Bataviae, 1.2-3.5% for Icterohaemorrhagiae, Cynopteri, Autumnalis, Australis, Pomona and Grippotyphosa. Sera from 35 animals reacted with the serovars from two or more serogroups. Of 7 sheep 1 was positive for Pomona and 18 goats proved to be negative. 10.2% of wild mammals were positive at titres 1 greater than or equal to 100, namely 3.5% for Icterohaemorrhagiae, 3.1% for Javanica, 1.7% for Pomona and 0.1-0.8% for Sejroe-Hebdomadis, Grippotyphosa Pyrogenes, Australis, Ballum, Bataviae, Cynopteri and Canicola. The sera of 10 animals were simultaneously positive with the serovars of two serogroups. Erinaceus albiventris, Eidolon helvum, Tadarida condylura and T. pumila, Cercopithecus aethiops, Genetta sp., Ichneumonia albicauda, Canis adustus and C. aureus, Felis silvestris, Leptailurus serval, Arvicanthis niloticus, Mus sp. and species from the subfamilies Tragelaphniae, Reduncinae and Gazellinae were serologically positive. The positivity rate in rodents was only 1.2%.

Brucellosis in the upper Nile region--Melut district, Sudan (report).

In the Melut district, South Sudan human and animal blood samples were investigated for Brucella abortus and Brucella melitensis. 9.2% of the investigated cattle and 16.2% of the green long-tailed monkies were Brucella abortus-positive. School children revealed a 3.7% positivity rate, Melut's hospital patients 5.2% and village children and adults 2.2%. However, only a small number of hospital patients was investigated. A small percentage of sheep and goats was investigated for Brucella melitensis revealing 12% positive results. 8.7% of cattle were positive. 2.2% of school children reacted in high titers against Brucella melitensis, 5.2% of Melut's patients and in the Melut district 3.6% of children and adults.

The application of PVP-iodine in developing countries.

In this report the possibilities for the application of PVP-iodine-preparations in the developing countries in the treatment of wounds, including burns and in diseases of the mucous membrane, eyes, mouth and genital region are discussed. The application proved particularly valuable where a high antibiotic resistance was found.

Serological investigation of measles (morbilli) in the Melut district, South Sudan.

In Sudan, measles are often not identified and are diagnosed and treated as "fever". Apart from this, the unimmunized population is an important factor, however, cold storage of the vaccine is not always possible. For this reason detailed instruction and introduction in diagnostic identification was given by our team of doctors. The contamination rate and antibody verification varies according to region. The highest percentage of 83% was reached in Melut among hospitalized patients. At the time of our investigation, immunization had not been carried out in this region.

Investigations in the problem of diarrhoea in the Melut district, South Sudan (1981-1982).

Studies of diseases associated with diarrhoea in the Melut district of South Sudan in the years 1981-1982 showed amoebic dysentery and Rota-virus to be predominate, whereby according to our previous results Yersinia, Campylobacter, Shigella and Salmonella infections also play a role. In addition other parasitological bacterial and viral-infections are presumed.

Serological testing of human blood samples for infectious diseases in the Abeokuta and the Minna Hospitals/Nigeria.

In serological investigations undertaken in two hospitals in Nigeria a total of 188 blood samples were examined and the following positive reactions for various diseases found: malaria 100%, leishmaniasis 9.5%, biharziasis 2.1%, yersinia 16.4%, Legionella pn. 9%, gonorrhea 6%, syphilis 6.9%, measles 65.4%, rubella 84%, cytomegalic 78.2%, herpes simplex 67%, varicella 30.8%, Resp. sync. virus 34.6%, influenza A 57.4%, influenza B 73.9%, para-influenza 1, 2, 3, 20.7%, 16.5%, 52.6%, adenovirus 25%, Mycoplasma pneumoniae 33.5%.

Serological investigations for the cause of diarrhoea among patients and personnel in the Minna and Abeokuta Hospitals/Nigeria.

188 blood samples were investigated for antibodies against bacteria causing diarrhoea in two hospitals in Minna and Abeokuta in Nigeria. Antibodies were found against Entamoeba histolytica, Yersinia enterocolitica, Campylobacter jejuni, Salmonella typhi, Salmonella paratyphi C, Shigella dysenteriae, Shigella sonnei, Shigella boydii, Shigella flexneri and Rotavirus.

[Gynecologic examinations in paraplegics]. / Gynäkologische Untersuchungen bei Querschnittgelähmten.

Following the introduction of a gynecological consultant in the Rehabilitation centre of Tobelbad, 102 paraplegic patients have been seen during a period of 30 months in a routine gynecological check-up. More than two thirds of patients with pathological findings did not have any complaint. Therefore they would not have consulted a gynecologist by their own. Among those one carcinoma in situ of the cervix uteri as well as one breast-cancer have been detected as the most severe cases. The difficulties of paraplegics to have gynecological routine check-ups or to continue those after the onset of the disablement is discussed.

The value of gynaecological examinations in spinal cord injured women.

The necessity for regular gynaecological examinations in tetraparaplegic and paraplegic women is pointed out. Outcomes of such examinations during a two and a half year period in the Rehabilitation Centre of Tobelbad illustrate this, as is shown in the tables.

[Report of a case of compound presentation with the vertex and both feet (author's transl)]. / Doppelter Fussvorfall bei Schädellage (Fallbericht).

A very rare case of compound presentation of a large mature infant, where both feet presented with the head is described. A similar case is only once mentioned in a report (2). The etiology of prolapsed extremities is discussed.