Periprosthetic Knee Infection after tumor excision complicated by Carbapenem Resistant Enterobacteriaceae

Case: A 65 year old Caucasian man presented with acute right knee PJI with Carbapenem-resistant Enterobacteriaceae (CRE) two months after undergoing right knee intra-articular mass removal with endoprosthetic reconstruction. The periprosthetic joint infection (PJI) was treated with revision with 1-stage static spacer and IV meropenem. Conclusion: CRE is a relatively uncommon cause of PJI that will infect patients who are immunosuppressed or have specific risk factors. This case demonstrates the importance of early diagnosis and treatment of CRE joint infections and the need for a multidisciplinary approach that includes aggressive surgical intervention and tailored antimicrobial therapy

Periprosthetic knee infection after benign tumor excision complicated by carbapenem resistant Enterobacteriaceae: A case report

Introduction Periprosthetic joint infection (PJI) is a major complication after total knee arthroscopy. Enterobacter is a rare cause of PJI. Case presentation We present a 65 year old Caucasian man who presented with acute right knee PJI with Carbapenem-resistant Enterobacteriaceae (CRE) two months after undergoing right knee intra-articular mass removal with endoprosthetic reconstruction. The periprosthetic joint infection (PJI) was treated with revision with 1-stage static spacer and IV meropenem. Discussion CRE is an uncommon cause of PJI, but when it does occur, it commonly infects patients who are immunosuppressed or have specific risk factors. For an immunocompetent patient with CRE PJI, we suggest further workup for other systemic disease. Conclusion This case demonstrates the importance of early diagnosis and treatment of CRE joint infections and the need for a multidisciplinary approach that includes aggressive surgical intervention and tailored antimicrobial therapy

Non-Syndromic Multi Focal Non-Ossifying Fibroma: A Diagnostic Challenge of Giant-Cell Rich Lesions

Background: Diagnosing GCL can be extremely difficult due to the rarity of these lesions. Histologically many benign GCL mimic each other and can further be mistaken for a malignant GCL. Additionally confusing the diagnosis, many benign GCL have significant morphological overlap. However, it is of utmost importance to arrive at an accurate diagnosis as treatment varies significantly based on the pathology. Our patient presentation highlights that differentiating GCLs can be a diagnostic challenge as illustrated. Our review of the literature found scarce reports of multifocal non-ossifying fibroma. In this case report, we describe a non-syndromic multifocal non-ossifying fibroma successfully treated with biopsy curettage and grafting. This patient was informed that her case would be submitted for publication and she agreed. Case: A 14 year-old-girl complained of left knee pain for 3 months and radiographic imaging showed a destructive bone lesion at her distal femoral metaphysis, the tibial tubercle, and proximal fibula. The patient had no history of trauma and reported no infectious, inflammatory, or syndromic symptoms. Core biopsy of the left thigh lesion showed findings most consistent with giant cell tumor. Bone scintigraphy revealed new lesions at the distal femur and proximal tibia on the contralateral (right) side. Patient was treated with biopsy curettage and grafting. Intra-operative frozen section permanent reads showed giant-cell rich non-ossifying fibroma. Due to discrepancy in core biopsy and intra-operative biopsy a independent pathology consult was requested on surgical specimens. Histologically, the differential diagnosis included non-ossifying fibroma, giant cell tumor of bone, and ossifying fibroma. Radiographic imaging combined with histology gave a final pathological diagnosis most consistent with non-ossifying fibroma. Conclusion: Differentiating non-syndromic multifocal non-ossifying fibroma from other giant cell rich lesions can be a diagnostic challenge. A combined approach using histology, clinical presentation, and radiology is imperative in reaching the correct diagnosis

Fibrous dysplasia in a Monkey

Fibrous dysplasia is a syndrome characterized by dysplastic fibro-osseous skeletal changes. The syndrome has been described in the literature under a number of different terms including osteodystrophia fibrosa, polyostotic osteitis fibrosa, regional fibrocystic disease, osteitis fibrosa cystica, and fibrous dysplasia. The disease has been reported in dogs, horses, swine, monkeys and man

Feline Cryptococcosis

Cryptococcosis is a disease common to most animals and is produced by a yeast-like fungus, Cryptococcus neoformans. The organism is round to ovid in shape, reproduces by budding and has a characteristic mucinous capsule

Utilizing Weightlifting for Cycling Performance

Abstract available in the 9th Annual Coaches and Sport Science College

Targeted analysis of four breeds narrows equine Multiple Congenital Ocular Anomalies locus to 208 kilobases

The syndrome Multiple Congenital Ocular Anomalies (MCOA) is the collective name ascribed to heritable congenital eye defects in horses. Individuals homozygous for the disease allele (MCOA phenotype) have a wide range of eye anomalies, while heterozygous horses (Cyst phenotype) predominantly have cysts that originate from the temporal ciliary body, iris, and/or peripheral retina. MCOA syndrome is highly prevalent in the Rocky Mountain Horse but the disease is not limited to this breed. Affected horses most often have a Silver coat color; however, a pleiotropic link between these phenotypes is yet to be proven. Locating and possibly isolating these traits would provide invaluable knowledge to scientists and breeders. This would favor maintenance of a desirable coat color while addressing the health concerns of the affected breeds, and would also provide insight into the genetic basis of the disease. Identical-by-descent mapping was used to narrow the previous 4.6-Mb region to a 264-kb interval for the MCOA locus. One haplotype common to four breeds showed complete association to the disease (Cyst phenotype, n = 246; MCOA phenotype, n = 83). Candidate genes from the interval, SMARCC2 and IKZF4, were screened for polymorphisms and genotyped, and segregation analysis allowed the MCOA syndrome region to be shortened to 208 kb. This interval also harbors PMEL17, the gene causative for Silver coat color. However, by shortening the MCOA locus by a factor of 20, 176 other genes have been unlinked from the disease and only 15 genes remain

Cyberbiosecurity: A New Perspective on Protecting U.S. Food and Agricultural System

Our national data and infrastructure security issues affecting the “bioeconomy” are evolving rapidly. Simultaneously, the conversation about cyber security of the U.S. food and agricultural system (cyber biosecurity) is incomplete and disjointed. The food and agricultural production sectors influence over 20% of the nation's economy ($6.7T) and 15% of U.S. employment (43.3M jobs). The food and agricultural sectors are immensely diverse and they require advanced technologies and efficiencies that rely on computer technologies, big data, cloud-based data storage, and internet accessibility. There is a critical need to safeguard the cyber biosecurity of our bio economy, but currently protections are minimal and do not broadly exist across the food and agricultural system. Using the food safety management Hazard Analysis Critical Control Point system concept as an introductory point of reference, we identify important features in broad food and agricultural production and food systems: dairy, food animals, row crops, fruits and vegetables, and environmental resources (water). This analysis explores the relevant concepts of cyber biosecurity from food production to the end product user (such as the consumer) and considers the integration of diverse transportation, supplier, and retailer networks. We describe common challenges and unique barriers across these systems and recommend solutions to advance the role of cyber biosecurity in the food and agricultural sectors