Diagnosis and Management of Infected Total Knee Arthroplasty§

Infection following total knee arthroplasty can be difficult to diagnose and treat. Diagnosis is multifactorial and relies on the clinical picture, radiographs, bone scans, serologic tests, synovial fluid examination, intra-operative culture and histology. Newer techniques including ultrasonication and molecular diagnostic studies are playing an expanded role. Two-stage exchange arthroplasty with antibiotic cement and 4-6 weeks of intravenous antibiotic treatment remains the most successful intervention for infection eradication. There is no consensus on the optimum type of interval antibiotic cement spacer. There is a limited role for irrigation and debridement, direct one-stage exchange, chronic antibiotic suppression and salvage procedures like arthrodesis and amputation. We examine the literature on each of the diagnostic modalities and treatment options in brief and explain their current significance

The interaction of Thrombospondins with extracellular matrix proteins

The thrombospondins (TSPs) are a family of five matricellular proteins that appear to function as adapter molecules to guide extracellular matrix synthesis and tissue remodeling in a variety of normal and disease settings. Various TSPs have been shown to bind to fibronectin, laminin, matrilins, collagens and other extracellular matrix (ECM) proteins. The importance of TSP-1 in this context is underscored by the fact that it is rapidly deposited at the sites of tissue damage by platelets. An association of TSPs with collagens has been known for over 25 years. The observation that the disruption of the TSP-2 gene in mice leads to collagen fibril abnormalities provided important in vivo evidence that these interactions are physiologically important. Recent biochemical studies have shown that TSP-5 promotes collagen fibril assembly and structural studies suggest that TSPs may interact with collagens through a highly conserved potential metal ion dependent adhesion site (MIDAS). These interactions are critical for normal tissue homeostasis, tumor progression and the etiology of skeletal dysplasias

A Precision Measurement of the Lambda_c Baryon Mass

The $\Lambda_c^+$ baryon mass is measured using $\Lambda_c^+\to\Lambda K^0_S K^+$ and $\Lambda_c^+\to\Sigma^0 K^0_S K^+$ decays reconstructed in 232 fb$^{-1}$ of data collected with the BaBar detector at the PEP-II asymmetric-energy $e^+e^-$ storage ring. The $\Lambda_c^+$ mass is measured to be $2286.46\pm0.14\mathrm{MeV}/c^2$. The dominant systematic uncertainties arise from the amount of material in the tracking volume and from the magnetic field strength.Comment: 14 pages, 8 postscript figures, submitted to Phys. Rev.

Larval development of the feline lungworm Aelurostrongylus abstrusus in Helix aspersa

The cat lungworm Aelurostrongylus abstrusus affects the domestic cat and other felids all over the world. Feline aelurostrongylosis is of importance in clinical feline medicine and is gaining more and more attention for the present expansion in the geographical range of A. abstrusus. Global warming and changes in phenology of snail intermediate hosts have been incriminated in this spreading. Helix aspersa, a potential vector of A. abstrusus, is endemic in most regions of the world, where it has become recently a pest outside its native Mediterranean range. The present work evaluated key features of larval development of A. abstrusus in H. aspersa at two different temperature conditions. The results showed that A. abstrusus may reach the infective stage in muscular foot and viscera of H. aspersa and that environmental temperatures may influence the biological cycle of the cat lungworm. In particular, the higher the average temperature, the higher the rate of larval development, i.e., about 50% of larvae of A. abstrusus reached the infective stage between temperatures of 18.8-29.5 °C, while only 17.8% of larvae completed their development at temperatures of 6.7-22 °C. Biological and epidemiological implications are discussed

Exposure to zoonotic vector-borne pathogens in cats from Italy

Feline Vector-Borne Diseases (VBDs) are of growing concern in veterinary medicine and public health, for their role for animal and human health [1,2,3]. Nevertheless, there is a lack of data both on the epidemiology and clinical features. Thus, increasing the knowledge on these aspects is of great importance to raise awareness of VBDs and improve diagnostic approaches in clinical settings. This study evaluated the exposure of cats living in Central and Southern Italy to different VBDs caused by the following pathogens: Bartonella henselae, Rickettsia felis, Rickettsia typhi, Anaplasma platys, Anaplasma phagocytophilum, Ehrlichia canis, Leishmania infantum and Dirofilaria immitis. One-hundred and sixty-seven privately owned cats from Abruzzo and Apulia regions (i.e. n. 122 and n. 45 respectively) were microscopically (blood smears) and serologically (Immunofluorescence Antibody Test -IFAT) tested. Out of these, 46 were also evaluated for anti-D. immitis antibodies. Complete blood count (CBC), and serum chemistry were obtained from 42 and 44 animals that scored positive to at least one of microscopic or serological evaluations, respectively. All samples were microscopically negative. Overall, 52/167 cats (31.1%) were positive at IFAT for at least one VBD, specifically 35 (28.7%) from Abruzzo and 17 (37.8%) from Apulia. Thirty cats (18%) were seropositive for B. henselae, while 18 (10.8%) and 7 (4.2%) tested positive for R. felis and R. typhi respectively. Five cats (3%) showed seroreaction against L. infantum, while 4 and 4 cats each showed seropositivity for A. phagocytophilum and E. canis. No cats were positive for A. platys. Two (4.3%) of 46 cats were positive for antibodies against D. immitis. Nine (17.3%) out of the 52 positive animals had at least one clinical sign, with non-specific and respiratory manifestations being the most recorded. Different CBC abnormalities were present in 33/42 (78.6%) cats while serum chemistry alterations in 35/44 (79.5%) animals, being basophilia and increased liver enzymes predominant. Twenty-five (48.1%) out of the 52 cats seropositive to at least one VBDs were housed indoor. These data suggest that cats may be frequently exposed to VBDs in the study areas, and that also privately owned cats are at risk. Control strategies remain crucial for the prevention of feline VBDs [4] and antiparasitic drugs should be administered regularly regardless the cat lifestyle and housing, to reduce the risk of infection and to protect both animal and human health

Exposure to zoonotic vector-borne pathogens in cats from Italy

Feline Vector-Borne Diseases (VBDs) are of growing concern in veterinary medicine and public health, for their role for animal and human health [1,2,3]. Nevertheless, there is a lack of data both on the epidemiology and clinical features. Thus, increasing the knowledge on these aspects is of great importance to raise awareness of VBDs and improve diagnostic approaches in clinical settings. This study evaluated the exposure of cats living in Central and Southern Italy to different VBDs caused by the following pathogens: Bartonella henselae, Rickettsia felis, Rickettsia typhi, Anaplasma platys, Anaplasma phagocytophilum, Ehrlichia canis, Leishmania infantum and Dirofilaria immitis. One-hundred and sixty-seven privately owned cats from Abruzzo and Apulia regions (i.e. n. 122 and n. 45 respectively) were microscopically (blood smears) and serologically (Immunofluorescence Antibody Test -IFAT) tested. Out of these, 46 were also evaluated for anti-D. immitis antibodies. Complete blood count (CBC), and serum chemistry were obtained from 42 and 44 animals that scored positive to at least one of microscopic or serological evaluations, respectively. All samples were microscopically negative. Overall, 52/167 cats (31.1%) were positive at IFAT for at least one VBD, specifically 35 (28.7%) from Abruzzo and 17 (37.8%) from Apulia. Thirty cats (18%) were seropositive for B. henselae, while 18 (10.8%) and 7 (4.2%) tested positive for R. felis and R. typhi respectively. Five cats (3%) showed seroreaction against L. infantum, while 4 and 4 cats each showed seropositivity for A. phagocytophilum and E. canis. No cats were positive for A. platys. Two (4.3%) of 46 cats were positive for antibodies against D. immitis. Nine (17.3%) out of the 52 positive animals had at least one clinical sign, with non-specific and respiratory manifestations being the most recorded. Different CBC abnormalities were present in 33/42 (78.6%) cats while serum chemistry alterations in 35/44 (79.5%) animals, being basophilia and increased liver enzymes predominant. Twenty-five (48.1%) out of the 52 cats seropositive to at least one VBDs were housed indoor. These data suggest that cats may be frequently exposed to VBDs in the study areas, and that also privately owned cats are at risk. Control strategies remain crucial for the prevention of feline VBDs [4] and antiparasitic drugs should be administered regularly regardless the cat lifestyle and housing, to reduce the risk of infection and to protect both animal and human health

Matrix-matrix interaction of cartilage oligomeric matrix protein and fibronectin

Recent work indicates that cartilage oligomeric matrix protein (COMP) plays an important role in extracellular matrix assembly and matrix-matrix protein interactions. In order to identify the proteins in extracellular matrix that interact with COMP, we used an ELISA-based solid-phase binding assay, which revealed a specific, high-affinity interaction between COMP and fibronectin. This interaction is concentration-dependent and saturable, and appears to occur under physiologically relevant conditions. Electron microscopy after negative staining and fragment binding analysis using the solid-phase assay revealed a predominant binding site for the COMP C-terminal globular domain to a molecular domain approximately 14 nm from the N-terminal domain of fibronectin, which can be inhibited by the presence of a polyclonal antibody specific for the C-terminal heptadecapeptide of COMP This interaction is further demonstrated in vivo by colocalization of both COMP and fibronectin in the chondrocyte pericellular matrix by laser confocal microscopy of chondrocytes grown in agarose culture, and by appositional and colocalization of these proteins in the growth plate of primates by immunohistochemistry. (C) 2002 Elsevier Science B.V./International Society of Matrix Biology. Published by Elsevier Science B.V. All rights reserved