BACKGROUND: A two-stage revision remains as the "gold standard" treatment for chronically infected total knee arthroplasties. METHODS: Forty-five septic knee prostheses were revised with a minimum follow-up of 5 years. Static antibiotic-impregnated cement spacers were used in all cases. Intravenous antibiotics according to sensitivity test of the culture were applied during patients' hospital stay. Oral antibiotics were given for another 5 weeks. Second-stage surgery was undertaken after control of infection with normal erythrocyte sedimentation rate and C-reactive protein values. Extensile techniques were used if needed and metallic augments were employed for bone loss in 32 femoral and 29 tibial revisions. RESULTS: The average interval between the first-stage resection and reimplantation was 4.4 months. Significant improvement was obtained with respect to visual analog scale pain and clinical and functional scores, and infection was eradicated in 95.6% of cases following a two-stage revision total knee arthroplasty. Radiographic evaluation showed suitable alignment without signs of mechanical loosening. CONCLUSIONS: This technique is a reasonable procedure to eradicate chronic infection in knee arthroplasty and provides proper functional and clinical results. However, it sometimes requires extensile surgical approaches that could imply arduous surgeries. Metallic augments with cementless stems available in most of the knee revision systems are a suitable alternative to handle bone deficiencies, avoiding the use of bone allografts with its complications.
Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*administration & dosage ; Arthroplasty, Replacement, Knee/*adverse effects ; Female ; Humans ; Knee Joint/physiology/radiography/surgery ; *Knee Prosthesis ; Male ; Middle Aged ; Prosthesis Design ; Prosthesis-Related Infections/*therapy ; Range of Motion, Articular ; Replantation/adverse effects/instrumentation/*methods ; Retrospective Studies ; Treatment Outcome

The purpose of this study was to investigate whether sporulated Neospora caninum oocysts, which had been stored for 46 mo in a 2% sulfuric acid solution at 4 degrees C, remain morphologically viable and infective to gerbils (Meriones unguiculatus). Six gerbils were orally inoculated with doses of 400 or 1,200 oocysts. Two mo after inoculation, the animals did not show any clinical signs, had no histological lesions, and were seronegative for N. caninum at 1: 50 in an immunofluorescent antibody test. PCR using the brain from each gerbil did not reveal N. caninum specific DNA. We conclude that oocysts preserved for 46 mo are not infective, despite being morphologically intact.
Acids ; Animals ; Brain/parasitology/pathology ; Cattle/parasitology ; Coccidiosis/parasitology/pathology/*veterinary ; Feces/parasitology ; Female ; Gerbillinae/*parasitology ; Neospora/genetics/growth & development/*pathogenicity ; Oocysts/*growth & development ; Polymerase Chain Reaction/methods ; Refrigeration ; Virulence

We reported here the first known case of natural infection of a lion (Panthera leo-Linnaeus, 1758) with Leishmania (Leishmania) chagasi (L. chagasi) in Brazil. The specimen was created by a circus handler in the state of Mato Grosso and was donated to the zoological park of the Federal University of Mato Grosso. Infection by L. chagasi was detected using a PCR-RFLP test. It was known that the domestic felids can act as reservoir of infection of L. chagasi in endemic areas, making it important that studies demonstrate their participation in the epidemiological chain. We demonstrate in this work that wild animals can have an important role in the epidemiological chain and must be considered in order to plan methods of control of this zoonosis.
Animal Diseases ; parasitology ; Animals ; Brazil ; Leishmania ; classification ; genetics ; Leishmaniasis ; veterinary ; Lions ; parasitology