Augmented reality fluoroscopy simulation of the guide-wire insertion in DHS surgery: A proof of concept study.

BACKGROUND: Hip fractures contribute to a significant clinical burden globally with over 1.6 million cases per annum and up to 30% mortality rate within the first year. Insertion of a dynamic hip screw (DHS) is a frequently performed procedure to treat extracapsular neck of femur fractures. Poorly performed DHS fixation of extracapsular neck of femur fractures can result in poor mobilisation, chronic pain, and increased cut-out rate requiring revision surgery. A realistic, affordable, and portable fluoroscopic simulation system can improve performance metrics in trainees, including the tip-apex distance (the only clinically validated outcome), and improve outcomes. METHOD: We developed a digital fluoroscopic imaging simulator using orthogonal cameras to track coloured markers attached to the guide-wire which created a virtual overlay on fluoroscopic images of the hip. To test the accuracy with which the augmented reality system could track a guide-wire, a standard workshop femur was used to calibrate the system with a positional marker fixed to indicate the apex; this allowed for comparison between guide-wire tip-apex distance (TAD) calculated by the system to be compared to that physically measured. Tests were undertaken to determine: (1) how well the apex could be targeted; (2) the accuracy of the calculated TAD. (3) The number of iterations through the algorithm giving the optimal accuracy-time relationship. RESULTS: The calculated TAD was found to have an average root mean square error of 4.2 mm. The accuracy of the algorithm was shown to increase with the number of iterations up to 20 beyond which the error asymptotically converged to an error of 2 mm. CONCLUSION: This work demonstrates a novel augmented reality simulation of guide-wire insertion in DHS surgery. To our knowledge this has not been previously achieved. In contrast to virtual reality, augmented reality is able to simulate fluoroscopy while allowing the trainee to interact with real instrumentation and performing the procedure on workshop bone models.

The effects of red bull energy drink on human performance and mood.

The effects of Red Bull Energy Drink, which includes taurine, glucuronolactone, and caffeine amongst the ingredients, were examined over 3 studies in a total of 36 volunteers. Assessments included psychomotor performance (reaction time, concentration, memory), subjective alertness and physical endurance. When compared with control drinks, Red Bull Energy Drink significantly (P < 0.05) improved aerobic endurance (maintaining 65-75% max. heart rate) and anaerobic performance (maintaining max. speed) on cycle ergometers. Significant improvements in mental performance included choice reaction time, concentration (number cancellation) and memory (immediate recall), which reflected increased subjective alertness. These consistent and wide ranging improvements in performance are interpreted as reflecting the effects of the combination of ingredients.

Distribution of bovine cysticercosis in Washington.

Data from slaughter plants (n = 3) and feedlots (n = 18) in eastern Washington were analyzed to characterize occurrence patterns of cysticercosis in Washington during 1984. Three concurrent peaks in cysticercosis rates (0.6/1,000 to 5/1,000 slaughtered cattle) were detected at 3 slaughter plants. Peaks were observed at 8 feedlots from December 1983 to March 1984, at 6 feedlots from April to July 1984, at 2 feedlots from August to October 1984, and at 3 feedlots from November 1984 to February 1985. Affected feedlots were not closely associated geographically and were feeding cattle from many, predominantly northwestern, origins. For 3 feedlots for which time in the feedlot was available for each slaughter shipment, an increase in cysticercosis rate with increasing time in the feedlot was noticed. Within these 3 feedlots, cases of cysticercosis were widely scattered spatially. The pattern of cysticercosis indicated human fecal contamination of a regionally available feed source. Of feedstuffs in use, potato waste, a byproduct of the processed potato industry, appeared to be the most likely source of Taenia saginata ova.

Arthropod transmission of Eperythrozoon coccoides in mice.

The association of Eperythrozoon coccoides infection in laboratory mice, with commonly encountered external parasites, was examined. Transmission of E. coccoides was achieved by infesting recipient mice with as few as 10 live Polyplax serrata immediately after they were obtained from donor mice infected with E. coccoides. Polyplax serrata removed from such hosts and fasted for 24 hours also were able to initiate E. coccoides infections in recipient mice. Transovarial transmission of E. coccoides through P. serrata was not demonstrated. Transmission of E. coccoides by Myocoptes musculinus, Myobia musculi and Radfordia affinis was not observed.

Comparison of ivermectin and thiabendazole for treatment of naturally occurring nematode infections of goats in Kenya.

The anthelmintic activity of thiabendazole (TBZ) at 88 mg kg-1 and ivermectin at 0.2 mg kg-1 was examined in goats with naturally-acquired nematode infections. In one experiment, a herd of 450 does was treated with TBZ or ivermectin at 4-week intervals for 9 months and efficacy was measured by reduction in faecal egg counts after each treatment. In a second experiment, 100 kids were treated with ivermectin and effectiveness measured at 2 and 4 weeks after treatment by comparison of their egg counts with those of nontreated controls. In a third experiment, efficacy of treatment with TBZ and ivermectin was determined by recovery of parasites at necropsy in a controlled test with 15 kids. The results indicated that TBZ generally did not reduce egg counts and only removed 19% of Haemonchus contortus in the controlled test. The efficacy of ivermectin approached 100% for reduction in egg counts and elimination of H. contortus. Species of Ostertagia, Trichostrongylus, Nematodirus and Oesophagostomum also were present in some subjects, but not in sufficient numbers to evaluate effectiveness of treatment.

Evaluation of lasalocid as a coccidiostat in calves: titration, efficacy, and comparison with monensin and decoquinate.

Two experiments were conducted to evaluate lasalocid as a coccidiostat in Holstein calves and to compare lasalocid with monensin and decoquinate. In experiment 1, calves in 3 groups (6 calves/group) were each inoculated with 500,000 sporulated oocysts, 88% of which were Eimeria bovis and 12% were E zuernii. Calves in each group were given lasalocid-medicated feed at 0.50 (group 3), 0.75 (group 4), or 1 mg/kg (group 5) of body weight/day for 45 days. Two control groups (6 calves/group) were also evaluated; calves in control group 2 were inoculated and nontreated, and calves in control group 1 were noninoculated and nontreated. At 0.50, 0.75, or 1 mg/kg/day, lasalocid was equally effective in preventing induced coccidiosis (E bovis and E zuernii) in calves. Compared with inoculated nontreated controls, treated calves had significantly (P less than 0.05) fewer oocysts in feces and had fewer clinical signs of coccidiosis from days 16 to 30 after inoculation. Experiment 2 was conducted to compare the effectiveness of monensin, lasalocid, and decoquinate for the prevention of experimentally induced coccidiosis. Calves (n = 48) were allotted into 4 groups (12 calves/group); each was inoculated orally with 275,000 sporulated oocysts, predominantly E bovis and E zuernii, and each was given nonmedicated feed (group 6) or feed medicated with 33 mg of lasalocid (group 7), decoquinate (group 8), or monensin (group 9)/kg of feed for 46 days. Calves given medicated rations had significantly (P less than 0.05) fewer oocysts in their feces and fewer clinical signs of coccidiosis than did calves given nonmedicated rations.(ABSTRACT TRUNCATED AT 250 WORDS)

Anthelmintics and drug resistance.

Equine anthelmintics and the resistance of nematode parasites to anthelmintics are reviewed. Recommendations are made for effective treatment of these parasites and for procedures that can be performed to minimize the problem in the future.

Pathologic changes in lambs with Ostertagia circumcincta infections associated with decreased infectivity of Haemonchus contortus.

Two experiments were done to examine the severity and type of abomasal lesions induced by moderate infections of Ostertagia circumcincta in young lambs and to examine the differences in pathologic changes in lambs with monospecific and combined infections of O circumcincta and Haemonchus contortus. Observations included descriptions of gross and microscopic changes in the abomasums, as well as quantitative analysis of the thickness of the mucosa, numbers of mucus-containing cells, and inflammatory cell accumulations. Seemingly, the changes in the abomasal mucosa of lambs inoculated with O circumcincta were mild and included dilated glands, focal accumulations of lymphocytes, and significant (P less than 0.05) numerical increases of mucus-containing cells, eosinophils, and globule leukocytes, and increase of mucosal thickness when compared with those in noninoculated controls. These differences were less pronounced in lambs given anthelmintic treatment to remove O circumcincta. When H contortus infections were superimposed upon O circumcincta infection, the changes were essentially the same as those described for O circumcincta plus a small, but significant (P less than 0.05), numerical increase of globule leukocytes. Abomasal mucosa of lambs inoculated only with H contortus was more roughened and hyperemic than that of lambs with combined infections, but contained few dilated glands and globule leukocytes. Our conclusions were that moderate infection with O circumcincta did not cause severe or permanent damage to the abomasal mucosa and that such infection decreased the severity of the gross lesions produced by H contortus.

Prevention and control of coccidiosis in goats with decoquinate.

Decoquinate was evaluated as a coccidiostat in domestic goats. Fifty goats less than 4 months of age were assigned to 5 groups (pens) of 10 goats each and were treated for 87 days with 0 (control), 0.3, 0.5, 1.0, or 4.0 mg of decoquinate in feed/kg of body weight. Goats were inoculated orally weight. Goats were inoculated orally with 30,000 oocysts, mainly Eimeria christenseni (74%) and E ninakohlyakimovae (20%) on day 19. Nontreated goats developed profuse watery diarrhea and tenesmus and gained weight poorly; 2 died. Treated goats did not develop clinical coccidiosis and gained significantly more weight (P less than 0.05), regardless of the dose used. Treated goats also had significantly fewer (P less than 0.05) oocysts in feces than did nontreated controls. Oocyst numbers were inversely related to dose; a more rapid decrease in oocyst numbers occurred as the dose was increased. At the doses used, decoquinate was safe in goats and was an effective drug for the prevention of clinical coccidiosis.

The susceptibility of the goat to Fasciola hepatica infections.

Mixed breed goats were infected with metacercariae of Fasciola hepatica and the resulting worm burdens were quantitated after primary and secondary exposure of the goats to the parasite. Mean length and width of the parasite recovered after all primary exposures were 1.91 +/- 0.2 cm and 0.91 +/- 0.2 cm, respectively. A mean of 71.8 +/- 5.9% of the flukes were recovered from all of the primary infections. In the secondary infections, the mean length and width of the flukes from the physically smaller population was 0.88 +/- 0.27 cm and 0.53 +/- 0.19 cm, respectively. A mean of 67 +/- 6.7% of the flukes were recovered from this secondary infection. It appears that the goat is susceptible to challenge infections with F. hepatica and that its response to this infection is much like that of sheep.

Interaction of bovine complement with Fasciola hepatica.

The host-parasite relationship of Fasciola hepatica in cattle was characterized by determining the effects of the parasite on the bovine complement system. Phosphosaline extracts of F. hepatica adults inhibited both the classical and alternative pathways of complement activation in normal bovine and human sera in a protein dose-dependent manner. The in vitro reaction of viable newly excysted juveniles (NEJ) with bovine serum (NBS) and with bovine serum containing antibodies specific to F. hepatica (IBS) resulted in no detectable changes in serum hemolytic complement activity for either pathway. This lack of complement consumption occurred even though these same flukes incubated in IBS for at least 24 h developed a precipitate that adhered to the parasite tegument, a feature that may reflect antibody--antigen reactions.

Enhancement of resistance of lambs to Haemonchus contortus by previous infection with Ostertagia circumcincta.

Two experiments were performed to determine whether previous infection of young lambs with Ostertagia circumcincta increased their resistance to the development of Haemonchus contortus and to explore alterations in the microenvironment of the abomasum related to the interaction. The parasitic infections were monitored with periodic fecal egg counts and by recovery and enumeration of parasites at necropsy of the lambs. Alteration of the microenvironment was examined by measurement of serum gastrin concentrations at critical times during both experiments. The results indicated that the numbers of H contortus were significantly (P less than 0.05) less in lambs which had O circumcincta infections before their exposure to H contortus. There was less reduction in lambs from which O circumcincta was removed (anthelmintic therapy) before their exposure to H contortus. Fecal egg counts also were significantly (P less than 0.05) less in the former group of lambs (exposed to both parasites) than those in lambs exposed only to H contortus. Serum gastrin values were significantly (P less than 0.05) increased in lambs infected with O circumcincta and indicated that the interaction observed could be due, in part, to alteration of abomasal pH.

Isolation of Fasciola hepatica metacercariae by density gradients.

Fasciola hepatica metacercariae were purified in high yield, removing contaminating cyst walls and plant material by step gradients consisting of 10 ml of 60% Percoll (density = 1.08 g ml-1) and 10 ml of 50% Metrizamide (density = 1.25 g ml-1). Greater than 90% of the metacercariae applied to the density gradients were recovered. These isolated metacercariae had an in vitro excystment rate of greater than 80%, which was the same excystment rate as metacercariae not subjected to density gradient centrifugation.

A review of the antigens of Fasciola hepatica.

The interaction between the antigens of Fasciola hepatica and the host immune response are reviewed. This paper evaluates not only more recent work, but the older literature as well. Antigens from each stage in the life cycle are considered with the idea of identifying those antigens with a potential for use in an effective vaccine. Antigens which cross-react with other parasite species are detailed as well as those that cross-react between different stages in the life cycle of F. hepatica. The objective of the review is to demonstrate for other investigators that vaccination against F. hepatica is a distinct possibility. We hope to encourage more investigators to initiate work on this aspect of an economically-important cosmopolitan parasite.

Bovine coccidiosis: protective effects of low-level infection and coccidiostat treatments in calves.

Twenty coccidia-free Holstein bull calves were allotted to groups to study effects of treatment with lasalocid and decoquinate on subsequent resistance to coccidiosis (Eimeria spp infections). Calves fed medicated rations of either drug at dosages of 50 mg/kg of feed (approx 1.2 mg/kg of body weight) had significantly fewer oocysts (P less than 0.01) than did nontreated controls regardless of other procedures used. Treated calves premunized with 2,000 oocysts/day for 5 days and later challenge inoculated with 200,000 oocysts did not develop diarrhea, unless the drugs were withdrawn from feed. Animals premunized (2,000 oocysts/day for 5 days) in absence of drug were no more resistant to the challenge inoculation than nonpremunized animals. These results indicated that lasalocid and decoquinate were efficacious coccidiostats and protected calves as long as they were administered. Cessation of drug treatment usually resulted in appearance of oocysts in feces and diarrhea. Premunization alone cannot be expected to prevent coccidiosis when animals are exposed to large numbers of oocysts.

Seasonal transmission of Fasciola hepatica to cattle in northwestern United States.

Sentinel steers were placed with 3 beef herds on irrigated pastures in southern Idaho for 1-month periods from May until November 1982 to determine the transmission pattern of Fasciola hepatica. Transmission was found to increase through the pasture season, reaching a peak during November. Overwintering of metacercariae or snail-borne stages was not found to contribute to infections in the year under study. A variety of species of Lymnaea were found to be available in southern Idaho as potential intermediate hosts. The enzyme-linked immunosorbent assay was found to be a good serologic indicator of light infections with F hepatica. The serum gamma-glutamyltransferase activity was not diagnostically significant when the degree of fluke infection was low.